Seizures in the Setting of Metoprolol Overdose

Beta-blockers are commonly prescribed for several conditions including hypertension, cardiac arrhythmias, coronary artery disease, and heart failure. Their physiologic effects also contribute to the often-devastating results when taken in excess. Beta-blocker overdosing can lead to bradycardia, hypotension, and ultimately cardiogenic shock. In this case report we review an 18-year-old female who ingested multiple drugs, including a significant amount of metoprolol, in a suicide attempt. Multiple interventions were initiated in the Emergency Department to combat the medications' negative cardiovascular and neurologic effects. Despite these interventions, the patient had a seizure followed by multiple cardiac arrest events, leading to anoxic brain injury and eventually the declaration of brain death. The case underscores the challenges in managing beta-blocker overdose and highlights the need for vigilance in recognizing and treating its potentially life-threatening complications.