Non-Accidental Flecainide Overdose A Case Report.

Abstract

Flecainide acetate is an antiarrhythmic drug used in the treatment of supraventricular arrhythmias. Flecainide causes very rare but often serious intoxications. These intoxications happen either due to a non-accidental overdose or because of a narrow therapeutic index in a patient who suffers from cardiomyopathy or has electrolyte abnormalities. We report an original case of a patient who had taken a high dose of flecainide with the aim of suicide. The patient suffered a cardiogenic shock with complications of lactic metabolic acidosis. Fast diagnosis is essential to reduce the high morbidity and mortality of this intoxication. The treatment plan is symptomatic. It aims at eliminating the poison and compensating cardiac function by treating the shock and the electrolyte imbalances. This allowed us to swiftly regain normal electrical and mechanical cardiac function in our patient. 3 weeks after the psychiatric consultation no sequelae were found. This case highlights that thorough history is essential in order to determine the diagnosis of a drug intoxication since the range of used products is wide. On the other hand, in case of any intoxication, while we apply a specific treatment, a well-managed, systematic, symptomatic treatment is essential to reduce morbidity and mortality.