Abstract
A 41-year-old woman presented unconscious with fixed dilated pupils following a massive overdose of carbamazepine and an unknown quantity of venlafaxine prescribed for the management of bipolar affective disorder. Her course in the intensive care unit was marked by a number of complications related to the overdose including prolonged coma, seizures and cardiac arrest. The patient eventually recovered to leave hospital.
References
1.
Adams R.D.
,
Victor M.
,
Ropper A.H.
Principles of Neurology. 6th ed. New York : McGraw Hill 1997 .
2.
Bates D.
The management of medical coma . J Neurol Neurosurg Psychiatry 1993 ; 56 : 589 –598 .
3.
Jones A.L.
,
Proudfoot A.T.
Features and management of poisoning with modern drugs used to treat epilepsy . QJM 1998 ; 91 : 325 –332 .
4.
Seymour J.F.
Carbamazepine overdose. Features of 33 cases . Drug Saf 1993 ; 8 : 81 –88 .
5.
Apfelbaum J.D.
,
Caravati E.M.
,
Kerns W.P.
,
Bossart P.J.
,
Larsen G.
Cardiovascular effects of carbamazepine toxicity . Ann Emerg Med 1995 ; 25 : 631 –635 .
6.
O'Griofa F.M.
,
Voris J.C.
Neuroleptic malignant syndrome associated with carbamazepine . South Med J 1991 ; 84 : 1378 –1379 .
7.PoisIndex. Toxicologic managements: Venlafaxine. Micromedex, Inc. Vol. 98 .
8.PoisIndex. Toxicologic managements: Carbamazepine. Micro-medex, Inc. Vol. 98 .
9.
Sullivan J.B. Jr
,
Rumack B.H.
,
Peterson R.G.
Acute carba-mazepine toxicity resulting from overdose . Neurology 1981 ; 31 : 621 –624 .
10.
Rowland L.P.
, ed. Merritt's Textbook of Neurology. 9th Ed. Baltimore, Williams and Wilkins 1995 .
11.
Worthley L.I.G.
Synopsis of Intensive Care Medicine. Edinburgh , Churchill Livingstone 1994 .
12.
Ashworth B.
The pupil . Q J Med 1987 ; 64 : 549 –555 .
13.
Feske S.K.
Coma and confusional states—emergency diagnosis and management . Neurol Clin Nth Am 1998 ; 16 : 237 –254 .