Successful Treatment With Intravenous Lipid Emulsion of Accidental Amantadine Overdose: A Case Report

A 2.5-year-old, 4.9 kg, Chinese Crested was accidentally administered a dose of 43.5 mg/kg of amantadine, resulting in the rapid onset of tremors, agitation, vertical nystagmus, and lack of pupillary light reflex in one eye. After unsuccessful treatment with methocarbamol, a 1.5 mL/kg bolus of 20% intravenous lipid emulsion therapy was initiated followed by a 0.25 mL/kg/min continuous rate infusion. All clinical signs secondary to the amantadine toxicity resolved following intravenous lipid emulsion therapy and remained normal on 24 h, day 5, day 18, and day 50. This represents the first report of amantadine toxicity in a clinical setting and is the first case showing that intravenous lipid emulsion therapy could be an effective treatment for amantadine toxicity.