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Acute carbamazepine toxicity resulting from overdose

University of Colorado Health Sciences Center School of' Medicine (Drs. Sullivan, Rumack, and Peterson), the B. F. Stolinsky Laboratories (Dr. Rumack), and the Rocky Mountain Poison Center (Drs. Sullivan and Rumack), Denver General Hospital, Denver, Co.

Four patients with an acute overdose of carbamazepine were examined with serial blood level determinations. The clinical spectrum consisted of coma, respiratory depression, seizures, myoclonus, nystagmus, hyperreflexia, hyporeflexia, delayed gastric emptying with cyclic coma, ataxia, sinus tachycardia, and atrioventricular conduction delay. Carbamazepine elimination half-lives varied from 10 to 29 hours, and in one case carbamazepine-l0, 11-epoxide was measured and had a half-life of 24 hours.

Address correspondence and reprint requests to Dr. Sullivan, Assistant Professor of Pediatrics, Emergency Department, University of Colorado Health Sciences Center, Box B-212,4200 East Ninth Avenue, Denver, Co 80262.

This work was supported in part by Grant No. NIGMS 2531503 and a grant from McNeil Consumer Products Company, Fort Washington, PA.

Accepted for publication July 29, 1980.

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