Oxcarbazepine overdose
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Reactions 1257 - 20 Jun 2009 O S Oxcarbazepine overdose Somnolence: case report A 13-year-old boy with autism exhibited somnolence after accidentally ingesting an overdose of oxcarbazepine [Trileptal], which had been prescribed for aggression. Autism spectrum disorder was diagnosed at age 4 years and the boy had been receiving risperidone [Risperdal Flas] from age 10 years. Oxcarbazepine 300mg twice daily had been added 6 months earlier to manage persistent aggression. He vomited shortly after ingesting 250mL of oxcarbazepine solution 60 mg/L. On admission, he was somnolent but arousable to painful stimuli [time to reaction onset not stated]; his Glasgow Coma Scale score was 13. His BP, pulse and respiratory rate were 105/47, 75 beats/min and 15 breaths/min, respectively, and his oxygen saturation (room air) was 99%. ECG and laboratory test results were within normal limits. The boy was treated with activated charcoal (2 doses with a 4-hour interval), and transferred to a paediatric ICU. He remained haemodynamically stable and his somnolence improved over a 12-hour period. While in the ICU, he displayed occasional self-limited episodes of violence. Analysis revealed a serum oxcarbazepine concentration of 7.9 mg/L 2 hours postingestion; the corresponding 10-monohydroxycarbazepine * (MHD) concentration was 34.6 mg/L. Oxcarbazepine was rapidly metabolised and was undetectable at 8 and 24 hours postingestion. His MHD concentration increased to 46.6 mg/L 8 hours postingestion, then steadily decreased thereafter. Oxcarbazepine and risperidone were restarted without incident 2 days postadmission. The boy was then discharged. * active metabolite of oxcarbazepine Pedrini M, et al. Acute oxcarbazepine overdose in an autistic boy. British Journal of Clinical Pharmacology 67: 579-581, No. 5, May 2009 - Spain 801146096 1 Reactions 20 Jun 2009 No. 1257 0114-9954/10/1257-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Oxcarbazepine overdose
Reactions 1257 - 20 Jun 2009
O SOxcarbazepine overdose
Somnolence: case reportA 13-year-old boy with autism exhibited somnolence
after accidentally ingesting an overdose of oxcarbazepine[Trileptal], which had been prescribed for aggression.
Autism spectrum disorder was diagnosed at age 4 yearsand the boy had been receiving risperidone [Risperdal Flas]from age 10 years. Oxcarbazepine 300mg twice daily hadbeen added 6 months earlier to manage persistentaggression. He vomited shortly after ingesting 250mL ofoxcarbazepine solution 60 mg/L. On admission, he wassomnolent but arousable to painful stimuli [time to reactiononset not stated]; his Glasgow Coma Scale score was 13.His BP, pulse and respiratory rate were 105/47,75 beats/min and 15 breaths/min, respectively, and hisoxygen saturation (room air) was 99%. ECG and laboratorytest results were within normal limits.
The boy was treated with activated charcoal (2 doseswith a 4-hour interval), and transferred to a paediatric ICU.He remained haemodynamically stable and hissomnolence improved over a 12-hour period. While in theICU, he displayed occasional self-limited episodes ofviolence. Analysis revealed a serum oxcarbazepineconcentration of 7.9 mg/L 2 hours postingestion; thecorresponding 10-monohydroxycarbazepine* (MHD)concentration was 34.6 mg/L. Oxcarbazepine was rapidlymetabolised and was undetectable at 8 and 24 hourspostingestion. His MHD concentration increased to46.6 mg/L 8 hours postingestion, then steadily decreasedthereafter.
Oxcarbazepine and risperidone were restarted withoutincident 2 days postadmission. The boy was thendischarged.
* active metabolite of oxcarbazepine
Pedrini M, et al. Acute oxcarbazepine overdose in an autistic boy. British Journalof Clinical Pharmacology 67: 579-581, No. 5, May 2009 - Spain 801146096
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Reactions 20 Jun 2009 No. 12570114-9954/10/1257-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
