Suicidal attempt with caffeine overdose treated with dexmedetomidine: a case report

J Med Case Rep. 2021 Jan 16;15(1):11. doi: 10.1186/s13256-020-02611-6.

Abstract

Background: Caffeine is a widely used dietary stimulant, and cases of caffeine overdoses, sometimes leading to death, are increasing. We encountered a case of caffeine intoxication resolved with administration of the sedative agent dexmedetomidine.

Case presentation: We administered dexmedetomidine for sedation and to suppress sympathetic nerve stimulation in the case of an 18-year-old Japanese male who ingested a massive dose of caffeine with the intention of committing suicide. The patient was in an excited state and had hypertension, sinus tachycardia, and hypokalemia with prominent QT prolongation. After dexmedetomidine administration, the patient's mental state, hemodynamics, and electrolyte levels were improved immediately. He was discharged without any sequelae 3 days later.

Conclusion: Cases of acute caffeine intoxication with agitation, sympathetic overactivity and adverse cardiac events would benefit with dexmedetomidine treatment.

Keywords: Caffeine; Dexmedetomidine; Overdose; Poisoning; Suicide.

Publication types

  • Case Reports

MeSH terms

  • Acidosis, Lactic / chemically induced
  • Acidosis, Lactic / drug therapy
  • Adolescent
  • Antidotes / therapeutic use
  • Caffeine / poisoning*
  • Central Nervous System Stimulants / poisoning*
  • Charcoal / therapeutic use
  • Dexmedetomidine / therapeutic use*
  • Drug Overdose / drug therapy*
  • Electrocardiography
  • Gastric Lavage
  • Humans
  • Hypertension / chemically induced
  • Hypertension / drug therapy
  • Hypnotics and Sedatives / therapeutic use*
  • Hypokalemia / chemically induced
  • Hypokalemia / drug therapy
  • Long QT Syndrome / chemically induced
  • Long QT Syndrome / drug therapy
  • Male
  • Potassium / therapeutic use
  • Suicide, Attempted*
  • Tachycardia / chemically induced
  • Tachycardia / drug therapy

Substances

  • Antidotes
  • Central Nervous System Stimulants
  • Hypnotics and Sedatives
  • Charcoal
  • Caffeine
  • Dexmedetomidine
  • Potassium