Severe venlafaxine poisoning successfully rescued with veno-arterial extracorporeal membrane oxygenation: A case report

doi:10.12998/wjcc.v13.i33.113560

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Nov 26, 2025 (publication date) through Jan 5, 2026

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World Journal of Clinical Cases

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Case Report

World J Clin Cases. Nov 26, 2025; 13(33): 113560
Published online Nov 26, 2025. doi: 10.12998/wjcc.v13.i33.113560

Severe venlafaxine poisoning successfully rescued with veno-arterial extracorporeal membrane oxygenation: A case report

Kurumi Mori, Yoshito Kamijo, Tomoki Doi, Hiroko Abe, Ichiro Takeuchi

Kurumi Mori, Department of Emergency and Critical Care Medicine, Yokohama City University Medical Center, Yokohama 232-0024, Kanagawa, Japan

Kurumi Mori, Tomoki Doi, Department of Emergency Medicine, Yokosuka Kyosai Hospital, Yokosuka 238-8558, Kanagawa, Japan

Yoshito Kamijo, Department of Clinical Toxicology, Saitama Medical University, Saitama 3500495, Japan

Hiroko Abe, BioDesign Co., Ltd., Tokyo 113-0033, Tōkyō, Japan

Ichiro Takeuchi, Department of Emergency and Critical Care Medicine, Yokohama City University School of Medicine, Yokohama 232-0024, Kanagawa, Japan

Author contributions: Mori K contributed to the conception and design of the study, patient management, and drafting of the manuscript; Kamijo Y supervised the clinical toxicology aspects and critically revised the manuscript for important academic content; Doi T assisted with patient care; Abe H supported the toxicological analysis; Takeuchi I contributed to the overall supervision of the study and editing of the manuscript; All authors have reviewed and approved the final version of the manuscript.

Informed consent statement: Written informed consent was obtained from the patient’s family for publication of this case report and accompanying images.

Conflict-of-interest statement: All authors declare that they have no conflicts of interest to disclose.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Kurumi Mori, MD, Department of Emergency and Critical Care Medicine, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, Kanagawa, Japan. e123082b@yokohama-cu.ac.jp

Received: August 29, 2025
Revised: September 25, 2025
Accepted: November 5, 2025
Published online: November 26, 2025
Processing time: 84 Days and 23.5 Hours

Core Tip

Core Tip: A 31-year-old woman ingested a massive dose of venlafaxine (14.8 g) and initially showed only mild QTc prolongation. However, she developed ventricular fibrillation 15 hours post-ingestion. She was successfully managed with veno-arterial extracorporeal membrane oxygenation (VA-ECMO). This case highlights the potential for delayed but life-threatening cardiotoxicity in venlafaxine overdose and demonstrates the utility of VA-ECMO as a life-saving intervention. Continuous electrocardiographic monitoring beyond the early phase is essential even when initial findings are mild.