ArticleJournal of medical case reports2025
Fosphenytoin may be effective in shortening the half-life of lamotrigine in case of overdose: a case report.
Article in Journal of medical case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis case study highlights the efficacy of fosphenytoin in managing cardiac arrest and seizures caused by lamotrigine overdose. While activated charcoal and sodium bicarbonate are typically recommended for lamotrigine overdose, alternative treatment options are scarce if these measures prove ineffective. The half-life of lamotrigine at normal therapeutic doses has been reported to be shortened by the concomitant use of drugs that promote glucuronidation. However, there are currently no reports on the use of these drugs in cases of lamotrigine overdose. It was hypothesized that fosphenytoin, in addition to its anticonvulsant effects, promotes the glucuronidation of lamotrigine and may be effective in patients experiencing lamotrigine overdose. CASE PRESENTATION: A 26 year-old Japanese woman was admitted to the hospital with seizures after taking 2000 mg of lamotrigine. After arrival, she experienced cardiac arrest. The patient was diagnosed with fatal arrhythmia and seizures due to lamotrigine overdose. Chest compressions were initiated, and return of spontaneous circulation was achieved. Subsequently, the patient underwent tracheal intubation. Sodium bicarbonate and activated carbon were administered. Following admission, the patient experienced repeated seizures. Despite the administration of midazolam, the seizures persisted. Temporary cessation of seizures was achieved with the therapeutic dose of fosphenytoin. Subsequent seizures were effectively controlled with levetiracetam, fat emulsion, and thiopental. Ultimately, the patient regained consciousness and was discharged from the hospital. Her lamotrigine blood concentration upon admission was 48.68 μg/mL. The rate of decrease in blood concentration accelerated 15 hours after admission, reaching 6.79 μ/mL on the third day. The half-life of lamotrigine in the blood was 17.51 hours, indicating a shorter duration than what is considered normal. In addition to its anticonvulsant effect as an antiepileptic drug, fosphenytoin may have promoted the glucuronidation of lamotrigine and was effective in decreasing the blood concentrations of lamotrigine.
conclusionFosphenytoin administration may be effective for treating lamotrigine overdose.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.