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TOXICOLOGY AND POISON CONTROL

Evaluation of Lamotrigine Toxicity Reported to Poison Centers

Clinical Toxicology Fellow, Maryland Poison Center, School of Pharmacy, University of Maryland, Baltimore, MD

Wendy Klein-Schwartz, PharmD MPH

Associate Professor, Department of Pharmacy Practice and Science, School of Pharmacy, Maryland Poison Center, University of Maryland

Reprints: Wendy Klein-Schwartz PharmD MPH, Maryland Poison Center, 20 N. Pine St., Baltimore, MD 21201-1180, fax 410/706-7184, wkleinsc{at}rx.umaryland.edu

BACKGROUND: Lamotrigine is an antiepileptic drug for the treatment of partial and generalized seizures as well as bipolar disorder. Limited published information exists describing the clinical effects of lamotrigine overdose.

OBJECTIVE: To examine the toxicity of exposures to lamotrigine utilizing national poison center data.

METHODS: Data on single-substance exposures to lamotrigine reported to the American Association of Poison Control Centers Toxic Exposure Surveillance System in 2000 and 2001 were retrospectively analyzed.

RESULTS: There were 493 cases that met the inclusion criteria. The majority of exposures occurred within the age groups 20–59 years old (n = 198, 40.2%), followed by 4 years old (n = 173, 35.1%). Overall, the majority of patients (52.1%) exposed to lamotrigine in overdose experienced no toxic clinical effects. The most common clinical effects reported in overdose were drowsiness/lethargy (20.9%), vomiting (11%), nausea (5.1%), ataxia (4.9%), dizziness/vertigo (4.5%), and tachycardia (4.3%). Major clinical effects included coma (n = 6), seizures (n = 8), and respiratory depression (n = 3). Medical outcome was reported as minor in 150 (30.4%), moderate in 73 (14.8%), and major in 13 (2.6%) cases. There were no deaths.

CONCLUSIONS: These data demonstrate that the majority of patients exposed to lamotrigine in overdose experienced minor or no clinical effects. Although rare, serious effects can also occur.

Key Words: anticonvulsant, lamotrigine, toxicity

Published Online, September 7, 2004. www.theannals.com, DOI 10.1345/aph.1E192

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