Carbamazepine
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Reactions 1153 - 26 May 2007 Carbamazepine Carbamazepine intoxication: case report A 45-year-old man, who was admitted with alcohol dependence, developed carbamazepine intoxication during treatment with carbamazepine and tiapride for alcohol detoxification. On admission, the man had an ALT level of 645 U/L, an AST level of 324 U/L and a γ-glutamyl transferase level of 403 U/L. He started receiving carbamazepine 600 mg/day and tiapride after his first vegetative withdrawal symptoms developed. On day 3 of treatment, he developed clinical signs of acute carbamazepine intoxication. He had severe nausea and several vomiting episodes. Within 2 hours of his last medication, he had marked dizziness, an uncertain gait followed by ataxia, and visual disturbances with double vision. His BP increased to 150/90mm Hg (baseline 130/80) and he had a HR of 84 beats/min. An ECG showed sinus rhythm. Ten hours after his last medication, his serum carbamazepine concentration was 19 mg/L. He had mild carbamazepine intoxication according to Hruby et al’s criteria. Carbamazepine and tiapride were stopped immediately and the man received sorbitol. His carbamazepine concentration decreased to 16 mg/L within 4 hours and, after a further 12 hours, it had decreased to 10.8 mg/L. His clinical condition improved with alleviation of all of his intoxication symptoms. His carbamazepine concentration decreased rapidly and his liver enzyme levels gradually decreased, but he remained slightly sedated. After a further 48 hours, he was completely free of symptoms. Diehl A, et al. Carbamazepine intoxication. Complication of alcohol detoxification with combined carbamazepine and tiapride. Nervenarzt 78: 85-89, No. 1, Jan 2007 [German; summarised from a translation] - Germany 801073781 1 Reactions 26 May 2007 No. 1153 0114-9954/10/1153-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Carbamazepine
Reactions 1153 - 26 May 2007
Carbamazepine
Carbamazepine intoxication: case reportA 45-year-old man, who was admitted with alcohol
dependence, developed carbamazepine intoxication duringtreatment with carbamazepine and tiapride for alcoholdetoxification.
On admission, the man had an ALT level of 645 U/L, an ASTlevel of 324 U/L and a γ-glutamyl transferase level of 403 U/L.He started receiving carbamazepine 600 mg/day and tiaprideafter his first vegetative withdrawal symptoms developed. Onday 3 of treatment, he developed clinical signs of acutecarbamazepine intoxication. He had severe nausea and severalvomiting episodes. Within 2 hours of his last medication, hehad marked dizziness, an uncertain gait followed by ataxia,and visual disturbances with double vision. His BP increased to150/90mm Hg (baseline 130/80) and he had a HR of84 beats/min. An ECG showed sinus rhythm. Ten hours afterhis last medication, his serum carbamazepine concentrationwas 19 mg/L. He had mild carbamazepine intoxicationaccording to Hruby et al’s criteria.
Carbamazepine and tiapride were stopped immediately andthe man received sorbitol. His carbamazepine concentrationdecreased to 16 mg/L within 4 hours and, after a further12 hours, it had decreased to 10.8 mg/L. His clinical conditionimproved with alleviation of all of his intoxication symptoms.His carbamazepine concentration decreased rapidly and hisliver enzyme levels gradually decreased, but he remainedslightly sedated. After a further 48 hours, he was completelyfree of symptoms.Diehl A, et al. Carbamazepine intoxication. Complication of alcohol detoxificationwith combined carbamazepine and tiapride. Nervenarzt 78: 85-89, No. 1, Jan 2007[German; summarised from a translation] - Germany 801073781
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Reactions 26 May 2007 No. 11530114-9954/10/1153-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
