Pediatric ingestion of lamotrigine

Pediatric Neurology
Andrea G Zidd, Jason B Hack

Abstract

A 3-year-old female presented to the emergency department after ingesting forty-six 25-mg tablets of lamotrigine that resulted in sedation, rash, and transient elevation of liver function tests. Her initial physical examination was significant for marked somnolence and a lacy reticular blanching rash. Laboratory studies were all within normal limits except for mildly elevated liver function tests. Initial plasma lamotrigine level was found to be elevated above adult therapeutic levels (25.3 microg/mL). Treatment consisted of gastric lavage followed by activated charcoal. The patient was subsequently observed in the pediatric intensive care unit where symptoms and laboratory abnormalities promptly resolved, and she was discharged 24 hours later without further complication. This case report describes the largest single ingestion of lamotrigine ever reported in a pediatric patient. The patient exhibited significant somnolence, rash, and liver function test abnormalities with only a slight elevation of serum level of lamotrigine above adult therapeutic levels. More research is required to investigate the toxic profile of lamotrigine in pediatric patients.

References

Nov 7, 1998·Pediatric Neurology·G BriassoulisT Hatzis
Feb 23, 1999·Pediatric Dermatology·T S BrownJ P Callen
May 2, 2000·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·J A MessenheimerM E Risner
Jan 11, 2000·Emergency Medicine Clinics of North America·Y Yoon, A Jagoda

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Citations

Dec 23, 2016·Therapeutic Advances in Psychopharmacology·Akintunde AlabiJoe Reilly
Aug 11, 2007·Journal of Child Neurology·Muhannad DaanaItai Berger
Apr 22, 2010·The Annals of Pharmacotherapy·Benjamin R Close, Colin J Banks
Sep 16, 2010·Acta neurochirurgica·Angelo R Silva NetoRódio Luis Brandão Câmara
Sep 2, 2017·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Bader AlyahyaMartin Laliberté
Aug 19, 2021·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Kengo HatanakaYoshiyuki Haga

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