Reactions 955 - 14 Jun 2003

O SCarbamazepine overdose

Unconsciousness: case reportA 32-year-old woman became unconscious after consuming

an overdose of carbamazepine. She had been taking the agentfor epilepsy and was later found to have an underlyingdepressive disorder.

The woman became unconscious and was admitted tohospital after consuming a large quantity of carbamazepine;she was estimated to have taken approximately 150–200tablets of carbamazepine 200mg. Upon examination she wasresponsive to noxious stimuli, and had shallow irregularbreathing, generalised hypotonia and depressed deep tendonreflexes. Her pupils sluggishly reacted to light. Her serumcarbamazepine concentration was 25.67 µg/mL (therapeuticconcentration 4–10).

The woman was intubated and mechanically ventilated andshe underwent gastric lavage and charcoal instillation.However, her neurological status did not improve and hercarbamazepine concentration 58 hours after ingestion was22.58 µg/mL. She was therefore started on a 4-hour session ofhaemodialysis. After 2 hours her neurological status hadimproved significantly and her carbamazepine concentrationwas 12.26 µg/mL.

The woman was extubated within 40 hours of her admissionto hospital and she was discharged 3 days later takingcarbamazepine and fluoxetine.

Author comment: "[Haemodialysis] may be a goodtherapeutic option in removing carbamazepine from thecirculation in patients with severe carbamazepine overdose."Chetty M, et al. Carbamazepine poisoning: treatment with haemodialysis.Nephrology Dialysis Transplantation 18: 220, Jan 2003 - India 800863788

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Reactions 14 Jun 2003 No. 9550114-9954/10/0955-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved