Complete heart block and death following lamotrigine overdose

Context. Lamotrigine is used for both seizure and psychiatric disorders. Overdoses typically follow a benign course. Case details. A 19-year-old male with bipolar disorder ingested 4 g of lamotrigine. The patient suffered from multiple seizures, charcoal aspiration, respiratory arrest, prolongaton of the QRS interval on electrocardiogram, complete heart block, multiorgan failure and ultimately death. Discussion. We describe the emergency department (ED) and ICU course for this patient and briefly review the toxic effects of lamotrigine and the pharmacokinetics with and without hemodialysis.