Intentional overdose with tiagabine: an unusual clinical presentation

The Journal of Emergency Medicine
F Lee CantrellEd Himes

Abstract

Tiagabine (Gabitril) is a unique anticonvulsant that is prescribed for a variety of psychiatric disorders. We report a case of intentional self-poisoning with tiagabine. A 46-year-old woman was brought to the Emergency Department after being found confused and nonverbal while wandering in a field. Eighteen tablets (72 mg) of her tiagabine prescription were missing. Remarkable findings on initial examination were facial grimacing, flexure posturing of both upper extremities, and 7-mm, reactive pupils. She was uncommunicative and unable to follow commands. Vital signs, blood chemistries and a head CT scan were normal. Urine toxicology screening was negative. An extrapyramidal reaction was suspected and diphenhydramine 50 mg was administered without effect. Lorazepam 2 mg was given with significant improvement. She was admitted for observation and all symptoms resolved within 12 h of admission. Tiagabine overdose causes an unusual array of neurological symptoms, many similar to reported adverse effects during therapeutic use.

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Citations

Dec 12, 2007·Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology·Ziad N KazziBrent W Morgan
Dec 2, 2008·Neuropsychiatric Disease and Treatment·Jürgen Bauer, Déirdre Cooper-Mahkorn
Jan 31, 2006·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Henry A SpillerSuparna Kumar
Nov 21, 2007·Emergency Medicine Australasia : EMA·Richard A ForbesFrank F S Daly
Aug 14, 2020·Acta neurologica Belgica·Geoffroy HaririStephane Legriel

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