[Massive lamotrigine poisoning--case report].
Lamotrigine is a phenyltriazine derivative used as antiepileptic drug with pharmacological profile similar to phenytoin. It is chemically unrelated to the other antiepileptic drugs and mechanism of anticonvulsant action is that lamotrigine inhibits sodium channels, resulting in neuronal membrane stabilization and block of excitatory neurotransmitter release. Mean therapeutical dose of lamotrigine is 200 - 400 mg/day. Overdose experience with lamotrigine is limited. In severe cases of poisonings there were serious effects such as: coma, respiratory depression, recurrent seizures and intraventricular conduction disturbances. We report massive suicidal poisoning with lamotirigine unknown dose. Clinical course was severe--we observed deep coma, respiratory depression, epileptical state, ventricular disrhytmias, atrio-venticular heart block, cardiovascular shock, rhabdomyolysis and hypokalemia. There was ventricular fibrillation in course of poisoning. The patient was successfully resuscitated and discharged on 18 hospital day.
Instytut Medycyny Pracy i Zdrowia Srodowiskowego w Sosnowcu Regionalny Ośrodek Ostrych Zatruć z Oddziałem Toksykologii Klinicznej. m.kicka@imp.sosnowiec.pl
Mariusz
M
Kicka
Tomasz
T
Kłopotowski
Sebastian
S
Picheta
Anna
A
Bazylewicz
Łukasz
Ł
Miśkiewicz
D000328:Adult; D000927:Anticonvulsants / Q000506:poisoning*; D003128:Coma / Q000139:chemically induced*; D062787:Drug Overdose; D004827:Epilepsy / Q000188:drug therapy; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D012131:Respiratory Insufficiency / Q000139:chemically induced*; D012206:Rhabdomyolysis / Q000139:chemically induced; D012770:Shock, Cardiogenic / Q000139:chemically induced*; D013406:Suicide, Attempted; D014227:Triazines / Q000506:poisoning*; D014693:Ventricular Fibrillation / Q000139:chemically induced; D055815:Young Adult
D000927:Anticonvulsants; D014227:Triazines; D000077213:Lamotrigine