Patients with alteration in mental status, which usually includes a depressed level of consciousness, and patients with evidence of cardiotoxicity are best managed in the intensive care unit. Thioridazine has been shown to cause serious dysrhythmias both early in the clinical course and after a significant delay; patients ingesting this agent warrant electrocardiographic monitoring for at least 24 h, even if asymptomatic. —I4 Patients should receive appropriate psychiatric evaluation after emergency department assessment and treatment, if they are asymptomatic, have a physical examination and electrocardiogram without evidence of lingering toxicity, and are not believed to have ingested a piperidine phenothiazine. If psychiatric evaluation is unwarranted, they may be discharged from the emergency department.

Some basic caveats are listed in Table 155-4.

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