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Published on: October 2, 2020
Management of lamotrigine overdose using hemodialysis
Abhinav Agrawal1, Joshua N Nogar2, Seth Koenig1
1Division of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, Zucker School of Medicine at Hofstra/Northwell, New York, USA.
Abstract:
Lamotrigine [LTG] is primarily an anti-epileptic drug used to treat seizure disorders, depression, and bipolar disease. It is generally well tolerated with limited side effects reported during routine use. Adverse events after overdose include neurotoxicity in the form of sedation and seizure activity, as well as cardiopulmonary toxicity in the form of sodium-channel blockade and cardiovascular collapse. There is no consensus regarding the role of hemodialysis (HD) in management of lamotrigine toxicity. Based on pharmacological properties, LTG is a candidate for extracorporeal removal, however, the successful use of HD for the treatment of this poisoning is not well described. We report the case of a 44 year-old female after a LTG overdose that experienced prolonged sedation that was ultimately treated with HD with an excellent response.
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