Tachycardia carbamazepine

Acute massive carbamazepine intoxication has been reported in a 27-year-old man (83). The plasma concentration was 147 pmol/l. He had a sinus tachycardia and a leukocytosis. 

In 14 children under the age of 5 years with peak serum carbamazepine concentrations of 76-134 pmol/l after acute accidental overdose there was nystagmus in 12, drowsiness in 10, ataxia in four, and mild tachycardia in two (84). None died. 

The primary and common toxic event involves the CNS. Cardiac conduction delays and ventricular arrhythmias can be seen but are infrequent. Sinus tachycardia and hypotension are more commonly seen. In the few deaths directly attributable to carbamazepine toxicity ventricular dysrhythmias have been the terminal event. Coma, seizures, and respiratory depression are commonly seen in adults at levels greater than 40 rgmH (170 mmol H ). Status epilepticus has been reported. The incidence of serious toxicity is similar in adults and children. However, serum levels are less predictive in children. 

A. Ataxia, nystagmus, ophthalmoplegia, movement disorders (dyskinesia, dystonia), mydriasis, and sinus tachycardia are common with mild to moderate overdose. With more serious intoxication, myoclonus, seizures (including status epilepticus), hyperthermia, coma, and respiratory arrest may occur. Atrioventricular (AV) block and bradycardia have been reported, particularly in the elderly. Based on Its structure similarity to tricyclic antidepressants, carbamazepine may cause QRS and QT interval prolongation and myocardial depression however, in case reports of overdose, QRS widening rarely exceeds 100-120 msec and Is usually transient. 

A man with mania taking carbamazepine 1.2 g daily and lithium developed muscle rigidity, mild hyperpyrexia, tachycardia, sweating and som-... 

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