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A 20-year-old woman* developed severe hypertension, reduced consciousness, aspirational pneumonia, hypotension, bradycardia, collapse and vomiting following intentional overdoses of diazepam and midodrine.
The woman with post traumatic stress disorder, borderline personality disorder, and neurocardiogenic syncope was receiving midodrine 10mg three times daily, fluoxetine 20mg daily, and quetiapine 150mg at night. Later, she presented to a hospital, after collapsing at a night club. On arrival at the hospital, her GCS score was four, HR was 70 beats/minute, and systolic BP was 85-95 mmHg. Subsequently, she was intubated and admitted to the ICU. After 24 hours, she was extubated and discharged to the ward. On discharge her BP was 118/78mm Hg and HR was 80 beats/min. On questioning, she revealed taking an unknown quantity of diazepam...