Management overview for lamotrigine poisoning

Note: Urgently contact a clinical toxicologist or poisons information centre if severe lamotrigine poisoning is suspected.

Lamotrigine is a broad-spectrum antiepileptic drug that is also used to treat bipolar disorder and neuropathic pain, and for migraine prophylaxis.

Although lamotrigine poisoning generally causes minimal toxicity, it can cause refractory hypotension and seizures. Due to lamotrigine’s reversible monoamine oxidase inhibitor (MAOI) effect, it can cause serotonergic toxidrome if co-ingested with another serotonergic drug, and tyramine reactions through interaction with food that contains tyramine (eg cheese, wine, preserved meat, yeast products).

Management of lamotrigine poisoning includes supportive care, gastrointestinal decontamination with activated charcoal, monitoring for cardiovascular toxicity and seizures, and consideration of haemodialysis.

If severe lamotrigine poisoning is suspected, urgently contact a clinical toxicologist or poisons information centre (13 11 26).