A 27-year-old woman diagnosed with personality disorder whose baseline treatment consisted of carbamazepine 400 mg/day, venlatine 75 mg/day, lorazepam 5 mg/day and dipotassium clorazepate 15 mg/day.
The patient was admitted for attempted suicide after ingesting carbamazepine.
When he arrived at the emergency room, they had spent about five hours since ingestion of the drug.
The patient was conscious with Glasgow 7 and mydriatic pupils, with slight drowsiness and disorientation.
1,500 ml of isotonic saline and 1,500 ml of 5% dextrose were infused.
Blood pressure was 123 mmHg, heart rate was 90 beats/min and diuresis was 150-200 ml/h.
After several gastric lavages with activated charcoal, the serum level of carbamazepine was 31.2 μg/ml five hours after drug ingestion.
Other laboratory data showed: hematocrit 37%, hemoglobin 13 g/dl, leukocytes 12800/mm3, platelets 225,000/mm3, glucose 80 mg/dl, urea 33 mg/dl, creatinine 0.96 mg/dl total calcium
Normal ECG.
The patient was admitted to the intensive care unit 180ml for monitoring and, three hours after admission, hemoperfusion was started using a carbamazepine, activated charcoal (Adsmbroba 300ching Ga).
During the five hours after hemoperfusion, the patient remained hemodynamically stable with diuresis of 150 ml/h.
Post-perfusion carbamazepine level was 7.8 μg/ml, and 8 hours later 3.9 μg/ml.
Twenty-four hours later, the patient was discharged to follow-up psychiatric controls.
