Poisoning with the New Anticonvulsant Drugs: Clinical Findings and the Outcome

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Anesthesiology, Isfahan Clinical Toxicology Research Center, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Associate Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Associate Professor, Department of Pharmacotherapy, Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

5 Assistant Professor, Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Poisoning is one of the medical emergencies. Poisoning with new Anticonvulsant drugs such as lamotrigine, sodium valproate, topiramate and gabapentin has been observed alone or in combination with other drugs in the last few years. Therefore this study was performed regarding the poisoning with new anticonvulsant drugs with respect to demographic, clinical manifestations, length of hospital stay, outcome and correlation between the outcome and different variables.Methods: This study was a descriptive-analytical and cross-sectional study. Simple sampling method was performed in the Noor and AliAsghar Hospital on poisoning cases with new anticonvulsant drugs. Need to intubation, connected to ventilator and aspiration pneumonia were considered as outcome Statisticial analysis was done by SPSS17 using ANOVA, Student t-test and logistic regression.Findings: Poisoning with Sodium valproate was more common than Lamotrigine, Topiramate and Gabapentin. The Mean (SD) age of study population was 27.67 (9.74) years old. The most important prediciting factors in outcome incidence were sex (male), seizure, cardiovascular and respiratory symptoms in poisoning with Sodium valproate and seizure in poisoning with Lamotrigine. One death occurred in poisoning with Sodium valproate.  Conclusion: Average age of patient was about 27.67 years which may be due to the use of these drugs in the younger age groups. The higher length of hospital stay in patients with respiratory symptoms in Sodium valproate and Lamotrigine poisoning would be because of more complications (intubation, ventilation and aspiration penumonia) observed with these two drugs.

Keywords

References

  1. Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al. Harrison's Principles of Internal Medicine. New York: McGraw-Hill; 2008.
  2. Ford M, Delaney KA, Ling L, Erickson T. Clinical Toxicology. Philadelphia: Saunders; 2000.
  3. Trevor A, Katzung B, Masters S. Katzung & Trevor's Pharmacology. 8th ed. New York: McGraw-Hill; 2007.
  4. Veerapandiyan A, Gallentine WB, Winchester SA, Baker J, Kansagra SM, Mikati MA. Oculogyric crises secondary to lamotrigine overdosage. Epilepsia 2011; 52(3): e4-e6.
  5. Close BR, Banks CJ. Seizures secondary to lamotrigine toxicity in a two-year-old. Ann Pharmacother 2010; 44(6): 1112-5.
  6. Brandt C, Elsner H, Furatsch N, Hoppe M, Nieder E, Rambeck B, et al. Topiramate overdose: a case report of a patient with extremely high topiramate serum concentrations and nonconvulsive status epilepticus. Epilepsia 2010; 51(6): 1090-3.
  7. Rupasinghe J, Jasinarachchi M. Progressive encephalopathy with cerebral oedema and infarctions associated with valproate and diazepam overdose. J Clin Neurosci 2011; 18(5): 710-1.
  8. Wisniewski M, Lukasik-Glebocka M, Anand JS. Acute topiramate overdose--clinical manifestations. Clin Toxicol (Phila) 2009; 47(4): 317-20.
  9. Taylor P, Morin R, Parker K, Cohn D, Wang W. Different Age Groups, Different Recessions. Pew Research Center's, Social and Demographic Trends Project; 2009.
  10. Hassanian-Moghaddam H, Zarei MR, Kargar M, Sarjami S, Rasouli MR. Factors associated with nonbenzodiazepine antiepileptic drug intoxication: analysis of 9,809 registered cases of drug poisoning. Epilepsia 2010; 51(6): 979-83.
  11. Nixon AC, Doak MW, Crozier H, Crooks DP, Waring WS. Patterns of antiepileptic drug overdose differ between men and women: admissions to the Edinburgh Poisons Unit, 2000-2007. QJM 2009; 102(1): 51-6.
  12. Bernardes SS, Turini CA, Matsuo T. [Profile of suicide attempts using intentional overdose with medicines, treated by a poison control center in Parana State, Brazil]. Cad Saude Publica 2010; 26(7): 1366-72.
  13. Dehpour AR, Shafie A, Haji Rahim Khan S, Khosrogorji F, ortazavi N, Mehregan. A comprehensive Handbook of Drug Information. Tehran: Teimourzade; 2006.
  14. Auinger K, Muller V, Rudiger A, Maggiorini M. Valproic acid intoxication imitating brain death. Am J Emerg Med 2009; 27(9): 1177-6.
Journal of Isfahan Medical School
Volume 29, Issue 144 - Serial Number 144
May and June 2011
Pages 812-823

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History

  • Receive Date: 02 July 2011
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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