Lamotrigine is an anticonvulsant and mood stabilizer. It can have serious adverse effects if taken in a large overdose.
Chemical structure: phenyltriazine compound
Mechanism of action: inhibits voltage-gated sodium channels, decreasing release of glutamate and aspartate and inhibiting reuptake of serotonin, norepinephrine and dopamine.
Clinical features:
(1) seizures
(2) hypertension or hypotension
(3) tachycardia
(4) tachypnea
(5) altered mental status
(6) hyperreflexia, myoclonus and/or clonus
(7) serotonin syndrome
(8) rhabodmyolysis
(9) pancreatitis
(10) cardiovascular collapse
ECG changes:
(1) QRS prolongation
(2) QTc prolongation
(3) heart block
(4) junctional tachycardia
According to Alyahya et al, a serum concentration > 25 mg/L was associated with severe toxicity, while an ingestion >= 525 mg by a child <= 3.5 years of age was associated with severe CNS depression and seizures.
