In cases of overdosage, the symptoms of intoxication by melitracen especially of anticholinergic nature, dominate. More rarely, extrapyramidal disorder due to flupentixol occur.
Symptoms: Somnolence or irritability, agitation, hallucinations, anticholinergic effects (mydriasis, tachycardia, urinary retention, mucosal dryness, intestinal hypomotility), convulsions, pyrexia, depressed level of consciousness, coma, respiratory depression, cardiac symptoms [arrhythmias (ventricular arrhythmia, Torsade de pointes, ventricular fibrillation), cardiac failure, hypotension, cardiogenic shock], metabolic acidosis, hypokalaemia.
Treatment: Admission to hospital (intensive care unit). Treatment is symptomatic and supportive. Gastric aspiration and lavage even in a late stage after oral ingestion and treatment with activated charcoal. Measures to support the respiratory and cardiovascular systems should be instituted. Continuous electrocardiogram (ECG)-monitoring of cardiac function for 3-5 days. Epinephrine (adrenaline) should not be used, as further lowering of blood pressure may result. Convulsions may be treated with diazepam and extrapyramidal disorder with biperiden.
Adults have survived consumption of up to 100 tablets (melitracen 1,000 mg and flupentixol 50 mg) and in an almost 3-year old child, 27 tablets (melitracen 270 mg and flupentixol 13.5 mg).