ArticleJournal of the American College of Emergency Physicians open2026
Prolonged Dysesthesia After Massive Accidental Semaglutide Overdose: A Case Report.
Article in Journal of the American College of Emergency Physicians open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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3 authors.
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Abstract
The use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) has expanded rapidly worldwide for the treatment of obesity, accompanied by a parallel increase in medication errors and accidental overdoses. Gastrointestinal symptoms are the most commonly reported adverse effects in cases of supratherapeutic exposure, whereas neurologic manifestations remain poorly characterized. We report a case of a 50-year-old man with obesity receiving weekly semaglutide 2.4 mg who accidentally administered a total dose of 9.6 mg due to a pen-device handling error. Two days after the injection, he developed generalized burning dysesthesia and marked asthenia in the absence of nausea, vomiting, or abdominal pain. Laboratory tests performed 4 days after exposure were unremarkable. Symptoms gradually improved and resolved completely within 7 days without specific treatment. Clinical trial data suggest a possible dose-related signal for dysesthesia with high-dose oral semaglutide; however, reports of acute parenteral supratherapeutic exposure presenting with isolated neurologic symptoms are scarce. This case suggests that isolated dysesthesia may occur following semaglutide overdose and may follow a benign, self-limited course, a presentation relevant to emergency physicians given the increasing use of GLP-1 RAs.
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