Convulsions overdose-related

The acute effects of psychomotor stimulant overdoses are related to their CNS stimulant properties and may include euphoria, dizziness, tremor, irritability, and insomnia. At higher doses, convulsions and coma may ensue. These drugs are cardiac stimulants and may cause headache, palpitation, cardiac arrhythmias, anginal pain, and either hypotension or hypertension. Dextroamphetamine produces somewhat less cardiac stimulation. Chronic intoxication, in addition to these symptoms, commonly results in weight loss and a psychotic reaction that is often diagnosed as schizophrenia. 

Reports of overdose with maprotiline relate to doses of 750-3200 mg (21,22). The symptoms included impaired consciousness, convulsions, confusion, disorientation, visual hallucinations, and electrocardiographic changes similar to those seen with tricyclic compounds. Among 41 patients who had taken overdoses of maprotiline car-diotoxicity was equal to or greater than that of tricyclic drugs (23). Mania occurred in one case of maprotiline overdose (SEDA-17, 22). 

One of the putative benefits of mianserin is its alleged safety in overdose, which may be related to a reduced risk of cardiovascular adverse effects and convulsions. Data from the UK Committee on Safety of Medicines suggest that mianserin accounts for 11% of reported convulsions and 5.8% of use, putting it intermediate between amitriptyline and maprotiline (15). On the other hand, in the London Poisons Unit survey, involving 84 patients who took mianserin alone (up to 1000 mg), there were no deaths and no patients with convulsions, although this could represent a frequency of up to 3.6% (12). 

One of the putative benefits of mianserin is its alleged safety in overdose, which may be related to a reduced risk of cardiovascular adverse effects and convulsions. Data from the UK Committee on Safety of Medicines suggest that mianserin accounts for 11% of reported convulsions... 

The sjmptoms of overdosage are nausea, vomiting, headache, dizziness, tachycardia, dysrhythmias, vascular collapse, tremor, agitation, and convulsions. The highly variable interindividual differences in metabolism and disease-related alterations in metabohsm of the various formulations can result in iatrogenicaUy induced overdosage. The tendency of patients to increase the dose as their condition deteriorates is a second major source of overdosing. 

Systemically it is a stimulant to all parts of the central nervous system including the brain, the spinal cord, and the medulla. Its effects upon the brain are shown by an exaltation of the intellectual faculties similar to that which is produced by caffeine. In overdose it produces a delirium somewhat suggesting that of atropine, to which it is chemically related Its action upon the spinal cord is shown by increased activity of the reflexes but the convulsions which are seen in cocaine poisoning both in the lower animals and in man seem to be due to an action upon... 

In an open study of lacosamide in 69 patients with painful diabetic neuropathy the initial dose was followed by escalation by 100 mg/day up to a maximum of 400 mg/day [132 ]. Patients then entered a 20-week maintenance period after which they could opt to continue for up to about 2.5 years. The most commonly reported adverse events that were considered possibly related to the trial medication were headache (7%), dizziness (7%), tremor (4%), fatigue (6%), and diarrhea and nausea (4%). The adverse events occurred most often during the titration period. Seven patients withdrew because of adverse effects—electrocardiographic changes (n =2), dizziness and nausea (n = 1), chest pain and nausea (n = 1), dizziness, fatigue, and tinnitus (n = 1), possible stroke and convulsion (n = 1, this was considered a serious adverse event), accidental overdose (n = 1). 

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