title: Intentional overdose with tiagabine: an unusual clinical presentation.
abstract: Tiagabine (Gabitril) is a unique anticonvulsant that is prescribed for a variety of psychiatric disorders. We report a case of intentional self-poisoning with tiagabine. A 46-year-old woman was brought to the Emergency Department after being found confused and nonverbal while wandering in a field. Eighteen tablets (72 mg) of her tiagabine prescription were missing. Remarkable findings on initial examination were facial grimacing, flexure posturing of both upper extremities, and 7-mm, reactive pupils. She was uncommunicative and unable to follow commands. Vital signs, blood chemistries and a head CT scan were normal. Urine toxicology screening was negative. An extrapyramidal reaction was suspected and diphenhydramine 50 mg was administered without effect. Lorazepam 2 mg was given with significant improvement. She was admitted for observation and all symptoms resolved within 12 h of admission. Tiagabine overdose causes an unusual array of neurological symptoms, many similar to reported adverse effects during therapeutic use.
authors.affiliation: California Poison Control System, San Diego Division, San Diego, California, USA.
authors.forename: F Lee
authors.initials: FL
authors.lastname: Cantrell
authors.forename: Mike
authors.initials: M
authors.lastname: Ritter
authors.forename: Ed
authors.initials: E
authors.lastname: Himes
mesh_terms: D000927:Anticonvulsants / Q000506:poisoning*; D062787:Drug Overdose; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008874:Midazolam / Q000627:therapeutic use; D008875:Middle Aged; D009422:Nervous System Diseases / Q000139:chemically induced / Q000188:drug therapy / Q000473:pathology*; D009557:Nipecotic Acids / Q000506:poisoning*; D000078308:Tiagabine; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D006993:Hypnotics and Sedatives; D009557:Nipecotic Acids; D008874:Midazolam; D000078308:Tiagabine