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Life-threatening overdose with lamotrigine, citalopram, and chlorpheniramine
N Venkatraman1, D O'Neil, A P Hall
1Acute Care Common Stem, University Hospitals of Leicester NHS Trust, Intensive Care Unit, Leicester Royal Infirmary, Leicester, United Kingdom. navinda@doctors.org.uk
Abstract:
Lamotrigine is a commonly used agent for seizure control in epilepsy. There are limited data on the adverse effects of lamotrigine in overdose. We report a number of serious side-effects associated with a large overdose of lamotrigine. A 23-year-old female presented to the emergency department after taking an intentional overdose of 9.2 g of lamotrigine, 56 mg of chlorpheniramine, and 220 mg of citalopram. On admission, she had a reduced level of consciousness and electrocardiographic abnormalities; a widened QRS and a prolonged corrected QT (QTc) interval. Prompt treatment with early intubation, along with the use of magnesium for cardioprotection and administration of sodium bicarbonate may have aided in a quick recovery with a short intensive care stay and good outcome.
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