From the Research
Management of Accidental Overdose of Lamictal (Lamotrigine)
Overview of Lamotrigine Overdose
- Lamotrigine is an antiepileptic drug used for the treatment of partial and generalized seizures as well as bipolar disorder 1.
- The majority of patients exposed to lamotrigine in overdose experience minor or no clinical effects, although rare, serious effects can also occur 1, 2.
- Common clinical effects reported in overdose include drowsiness/lethargy, vomiting, nausea, ataxia, dizziness/vertigo, and tachycardia 1.
Toxic Effects of Lamotrigine Overdose
- The most commonly described toxic effects of lamotrigine are on the central nervous system, specifically seizures, movement disorders, and reduced consciousness 2.
- Other toxic effects include QTc interval and QRS complex prolongations, hypersensitivity reactions, serotonin syndrome, and rhabdomyolysis possibly due to seizures and/or agitation 2.
- Deaths have been recorded in some cases, with cardiovascular and neurological toxic effects described 2, 3.
Treatment Options for Lamotrigine Overdose
- Good supportive care is the mainstay of treatment for lamotrigine poisoning, which may include management of seizures, cardiac monitoring, and treatment of other symptoms as they arise 4.
- Multiple-dose activated charcoal may be considered as an option for treating lamotrigine poisoning, as it may shorten the elimination half-life of lamotrigine by inhibiting enterohepatic circulation 4.
Special Considerations
- Children may be at higher risk of lamotrigine toxicity due to their lower body weight and potential for higher doses per kilogram 5.
- The minimum dose of lamotrigine causing toxicity can be as low as 250 mg in children, highlighting the need for careful monitoring and dose adjustment in this population 5.