Management of lamotrigine overdose using hemodialysis

Am J Emerg Med. 2019 Aug;37(8):1603.e1-1603.e2. doi: 10.1016/j.ajem.2019.05.026. Epub 2019 May 15.

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.

Keywords: Hemodialysis; Lamotrigine; Overdose; Respiratory depression; Seizure.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anticonvulsants / blood
  • Anticonvulsants / poisoning*
  • Bipolar Disorder / drug therapy
  • Drug Overdose / blood
  • Drug Overdose / therapy*
  • Female
  • Humans
  • Lamotrigine / blood
  • Lamotrigine / poisoning*
  • Renal Dialysis

Substances

  • Anticonvulsants
  • Lamotrigine