We report a case of poisoning resulting from the use of Chinese proprietary medicines (CPM) containing antic-onvulsants phenytoin, carbamazepine and valproate. The manufacturer's information leaflets did not mention any of these prescription drugs. As a consequence, the patient was admitted comatose due to severe phenytoin poisoning. We are not aware of any reported case of severe poisoning due to CPM adulterated with anticonvulsants and this is possibly the first case.
References
1.
1 Lai CK , Chan AYW . Tetrahydropalmatine poisoning: diagnosis of nine adult overdoses based on toxicology screens by HPLC with diode-array detection and gas chromatography mass spectrometry . Clin Chem1999; 45(2): 229-236 .
2.
2 Chan TYK , Chan JCN , Tomlinson B , Critchley JAJH . Chinese herbal medicines revisited: a Hong Kong perspective . Lancet1993; 342: 1532-1534 .
3.
3 Tai TY , But PPH , Young K , Lau CP . Cardiotoxicity after accidental herb-induced aconite poisoning . Lancet1992; 340: 1254-1256 .
4.
4 Ng THK , Chan YW , Yu YL , et ao. Encephalopathy and neuropathy following ingestion of a Chinese herbal broth containing podophyllin . J Neurol Sci1991; 101: 107-113 .
5.
5 Yeung CY , Lee Fl , Wong HN . Effect of a popular Chinese herb on neonatal bilirubin protein binding . Biol Neonate1990; 58: 98-103 .
6.
6 Vanherweghen JL , Depierreux M , Tielemans C , et al. Rapidly progressive interstitial renal fibrosis in young women: association with slimming regimen including Chinese herbs . Lancet1993; 341: 387-391 .
7.
7 Huang WF , Wen KC , Hsiao ML . Adulteration by synthetic therapeutic substances of traditional Chinese medicines in Taiwan . J Clin Pharmocol1997; 37: 344-350 .
8.
8 Ko RJ . Adulterants in Asian patent medicines . NEJM1998; 339: 847-847 .
9.
9 Angell M , Kassirer JP . Alternative medicine-the risks of untested and unregulated remedies . NEJM1998; 339: 839-841 .
