Karaoulanis Sokratis E, Syngelakis Markos, Fokas Konstantinos
First Psychiatric Department, Aristotle University of Thessaloniki, Thessaloníki, Greece.
Ann Gen Psychiatry. 2016 Feb 24;15:6. doi: 10.1186/s12991-016-0093-3. eCollection 2016.
Lamotrigine is an effective anticonvulsant drug that has also been demonstrated to be effective in the treatment of bipolar disorder. We report a case of rhabdomyolysis after intentional overdose in a woman aged 48.
A 48-year-old female presented to the emergency department after an acute ingestion of 6 g of lamotrigine. The patient suffered from bipolar disorder, and she was taking lamotrigine and olanzapine. At that point, she had a major depressive episode, and she wanted to commit suicide. Activated charcoal was administered in the emergency department. Her vital signs were still normal, and she entered the Medical clinic, where she had been there for 2 days in a good condition. The hematological and biochemical results were normal. On the fourth day, the levels of creatine phosphokinase (CPK) showed remarkable increase (2500 IU/ml). Fluid and bicarbonate intravenous administration was performed, and CPK levels returned to normal after 3 days.
The majority of patients exposed to lamotrigine in overdose experienced no toxic clinical effects. The most common clinical effects are drowsiness and lethargy, vomiting, nausea, ataxia, dizziness/vertigo, and tachycardia. In this case report, the patient was alert and did not have any serious complications, except for mild rhabdomyolysis, which was the main consequence of lamotrigine overdose.
拉莫三嗪是一种有效的抗惊厥药物，也已被证明对双相情感障碍的治疗有效。我们报告一例48岁女性故意过量服用拉莫三嗪后发生横纹肌溶解的病例。
一名48岁女性在急性摄入6克拉莫三嗪后被送往急诊科。该患者患有双相情感障碍，正在服用拉莫三嗪和奥氮平。当时，她处于重度抑郁发作期，想要自杀。在急诊科给予了活性炭。她的生命体征仍正常，随后进入内科病房，在那里她状况良好地待了2天。血液学和生化检查结果正常。第四天，肌酸磷酸激酶（CPK）水平显著升高（2500 IU/ml）。进行了静脉补液和碳酸氢钠治疗，3天后CPK水平恢复正常。
大多数过量服用拉莫三嗪的患者没有出现中毒临床症状。最常见的临床症状是嗜睡、昏睡、呕吐、恶心、共济失调、头晕/眩晕和心动过速。在本病例报告中，患者神志清醒，除了轻度横纹肌溶解外没有任何严重并发症，轻度横纹肌溶解是拉莫三嗪过量的主要后果。
