[Carbamazepine poisoning]

Due to the increased indications of using carbamazepine, a higher number of intoxications is to be expected. A case report is given of a 42-year-old patient who took about 250 tablets (50 g) carbamazepine (Finlepsin) in a suicide attempt. The maximum serum level of carbamazepine was 118.74 mumol/l. After a gastric lavage and the use of activated charcoal the detoxication was carried out by forced diuresis and one-time haemodialysis. The unconscious patient was ventilated for 8 days after intubation. Two hours after admission three generalised seizures occurred. A long-term hypotension and electrolyte shifts were balanced and a bronchoscopy and lavage were necessary. Bronchopneumonia occurred as a complication. The patient became conscious on the 5th day of treatment, the extubation was accomplished on the 12th day and on the 15th day she was transferred to the psychiatric clinic for further treatment of the basic disease. Since a specific antidote does not exist, general intensive therapeutic measure after carbamazepine intoxication are discussed. After gastric lavage to eliminate the poison, the patient should receive hourly doses of activated charcoal plus vigorous cathartic-like solutions of mannitol and sorbitol and forced diuresis. In case of complicated coma haemoperfusion is recommended.