Premium
Deliberate self‐poisoning with tiagabine: An unusual toxidrome
Author(s) -
Forbes Richard A,
Kalra Harish,
Hackett L Peter,
Daly Frank FS
Publication year - 2007
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/j.1742-6723.2007.00973.x
Subject(s) - tiagabine , medicine , anesthesia , coma (optics) , vomiting , ingestion , anticonvulsant , epilepsy , psychiatry , physics , optics
Tiagabine is an anticonvulsant acting by selective inhibition of neuronal and glial gamma‐aminobutyric acid uptake, resulting in increased gamma‐aminobutyric acid‐mediated inhibition in the brain. Few reports in the literature describe the clinical course of severe tiagabine intoxication. A 44‐year‐old woman presented after deliberate self‐poisoning with 100 tiagabine 15 mg tablets (1500 mg; 25 mg/kg). Serum tiagabine level was 4600 µg/L (1725 mmol/L) at presentation, 20 times levels associated with therapeutic dosing. Intoxication was manifested by profuse vomiting, coma, myoclonus, generalized rigidity, bradycardia, hypertension, hypersalivation and generalized piloerection within 2 h of ingestion. The patient was intubated and management was supportive. Coma lasted until 10 h post‐ingestion, but recovery was complicated by severe agitated delirium lasting 12 h. The patient recovered fully within 26 h of ingestion. Tiagabine deliberate self‐poisoning was associated with the rapid onset of coma and an unusual toxidrome. Recovery, although complicated by agitated delirium, was complete within 26 h.