title: A fatal overdose of carbamazepine: case report and review of literature.
abstract: Carbamazepine is a drug of choice for partial epilepsies, certain affective disorders and neuralgic pain syndromes. It has an excellent safety record; however, overdose can be dangerous. This article reports one of the very few fatalities from carbamazepine overdosage, in an individual with a peak carbamazepine level of 54 mg/L. Manifestations of this and other major carbamazepine overdoses reviewed from the literature were similar to those of tricyclic - anticholinergic overdose, with coma, hypotension, respiratory depression, cardiac arrhythmias, abnormal movements and seizures. Fatality from cardiovascular causes occurred despite decline of serum carbamazepine levels to the putatively non-toxic range, emphasizing the potential for delayed consequences of carbamazepine overdosage. Management should consist of vigorous gastric lavage and installation of activated charcoal, full supportive care in a monitored setting and consideration of early charcoal hemoperfusion, before the patient becomes hypotensive.
authors.affiliation: Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205.
authors.forename: R S
authors.initials: RS
authors.lastname: Fisher
authors.forename: B
authors.initials: B
authors.lastname: Cysyk
mesh_terms: D000328:Adult; D002220:Carbamazepine / Q000506:poisoning*; D004833:Epilepsy, Temporal Lobe / Q000188:drug therapy; D006801:Humans; D008297:Male
chemical_list: D002220:Carbamazepine