Observation and patient disposition after antiepileptic drug poisoning
Specific advice on observation and patient disposition after poisoning is given for the following antiepileptic drugs:
- barbiturates
- benzodiazepines
- carbamazepine and oxcarbazepine
- lamotrigine
- phenytoin
- pregabalin and gabapentin
- sodium valproate
- tiagabine
- topiramate.
For all other antiepileptic drugs, admit patients with evolving toxicity. Medical observation is recommended for:
- symptomatic patients
- patients with deliberate self-poisoning
- drug-naive children who have accidentally ingested a potentially toxic dose of an antiepileptic drug (see Potential toxic doses of some antiepileptic drugs in drug-naive children for potential toxic doses).
Discharge patients if they remain asymptomatic for at least 6 hours after ingestion. Drug-naive children who have accidentally ingested doses less than those in Potential toxic doses of some antiepileptic drugs in drug-naive children can be discharged if they are asymptomatic and can be supervised in a safe environment.
Sedative drugs can continue to cause significant cognitive impairment for several days following exposure. Advise patients not to drive or operate machinery for at least 3 days after discharge.