Pediatric Carbamazepine Intoxication

Ernest S. Stremski, William B. Brady, Kris Prasad, Halim A. Hennes

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


Study objective: To describe the clinical effects of carbamazepine ingestion in a pediatric population. Design: Case series of prospectively evaluated patients and a historical retrospective group. Participants: All patients younger than 18 years who presented to an urban emergency department with history of carbamazepine ingestion and positive laboratory confirmation. Interventions: Patient demographics, findings on physical examination, serum carbamazepine levels, analysis of 12-lead ECGs, and time and doses of activated charcoal were recorded. Results: Seventy-seven patients were enrolled, of whom 17 were evaluated prospectively. Serum carbamazepine levels were greater than 12 μg/mL (50 μmol/L) in 61 patients. In those 61 patients, mean peak serum level was significantly higher in patients with dystonic reactions (P =.009), coma (P =.002), and apnea (P =.008) than in patients without these symptoms. There was no significant difference in mean peak serum levels between patients with and without seizures. Serum carbamazepine half-life was significantly shorter (P =.022) in patients who received multiple doses of activated charcoal (8.2±1.6 hours) than in those who received a single dose (12.1±4.9 hours). Conclusion: Pediatric patients with suspected carbamazepine ingestion are at higher risk for dystonic reactions, coma, and apnea if the peak serum carbamazepine level exceeds 28 μg/mL (117 μmol/L). The development of seizures is not related to peak serum level. Multiple doses of activated charcoal can significantly shorten serum carbamazepine half-life. [Stremski ES, Brady WB, Prasad K, Hennes HA: Pediatric carbamazepine intoxication. Ann Emerg Med May 1995;25:624-630.].

Original languageEnglish (US)
Pages (from-to)624-630
Number of pages7
JournalAnnals of emergency medicine
Issue number5
StatePublished - May 1995

ASJC Scopus subject areas

  • Emergency Medicine


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