Lacosamide intoxication in attempted suicide.
The anticonvulsant drug lacosamide selectively enhances slow inactivation of voltage-gated sodium channels and has been shown to be an effective add-on treatment for partial-onset seizures. Common adverse events (frequency 10%) of lacosamide doses up to 600 mg/day include nonspecific central nervous system effects (e.g., dizziness, ataxia, diplopia, and somnolence). There are no human data regarding the safety of very high dosages of lacosamide. We report the clinical course of a patient with bitemporal epilepsy who ingested 12 g of lacosamide, 56 g of gabapentin, 2g of topiramate, and 2.8 g of zonisamide during a suicide attempt. The patient was found comatose and experienced repeated generalized tonic-clonic seizures, aspiration with subsequent pneumonia, hypotension, and an increase in PR interval. Complete physical recovery occurred after several days of supportive treatment. We conclude that intoxication with lacosamide, in combination with overdoses of multiple AEDs, can be survived without sequelae, even after ingestion of 12 g lacosamide.
Bauer
Sebastian
S
Department of Neurology, University of Marburg, Marburg, Germany. bauerse@med.uni-marburg.de
David Rudd
G
G
Mylius
Veit
V
Hamer
Hajo M
HM
Rosenow
Felix
F
D000081:Acetamides / Q000008:administration & dosage* / Q000633:toxicity; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000633:toxicity; D003128:Coma / Q000139:chemically induced; D004333:Drug Administration Routes; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D000078334:Lacosamide; D013406:Suicide, Attempted / Q000523:psychology*
D000081:Acetamides; D000927:Anticonvulsants; D000078334:Lacosamide