Movement Disorder Emergencies

A 35-year-old female patient was brought into the emergency department by EMS one weekend morning after being found down by her parents, with a chief complaint of altered mental status, confusion, and somnolence. Upon arrival the patient was drowsy but arousable and able to converse. She admitted to taking a handful of her muscle relaxant medicine (cyclobenzaprine) with some alcohol that prior evening when she had an argument with her boyfriend. Her past medical history included depression, for which she took escitalopram 10 mg daily. The muscle relaxant was given to her recently for an acute muscle spasm of her lower back. She denied any other drugs or medications.