Observation and patient disposition after lamotrigine poisoning

Admit patients with significant clinical effects (CNS depression, cardiotoxicity, seizures, serotonergic toxidrome) due to lamotrigine poisoning.

Discharge patients if they remain asymptomatic for at least 6 hours after ingestion.

Medical observation is recommended for drug-naive children who have accidentally ingested more than 10 mg/kg of lamotrigine. Drug-naive children who have accidentally ingested less than 10 mg/kg can be discharged if they are asymptomatic and can be supervised in a safe environment.

Due to lamotrigine’s reversible monoamine oxidase inhibitor (MAOI) effects, advise patients to follow a tyramine-free diet for 3 days after symptoms resolve.

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.