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Thirteen years of oxcarbazepine exposures reported to US poison centers: 2000 to 2012.
Hum Exp Toxicol. 2016 Oct; 35(10):1055-9.HE

Abstract

OBJECTIVES

Oxcarbazepine (OXC) is a 10-keto analogue of carbamazepine used in patients with partial and secondary generalized seizures. We evaluated ingestions of OXC reported to US poison centers for adverse effects from supratherapeutic doses and/or overdose.

METHOD

Retrospective analysis of data reported to National Poison Data System from single-substance OXC ingestions between January 2000 and December 2012.

RESULTS

There were 18,867cases with a mean of 1451 exposures/year. The patients were predominantly adults with 5464 exposures in children <6 years (29%). The most commonly reported clinical effects were drowsiness (n = 4703, 25%), vomiting (n = 1559, 8%), tachycardia (n = 590, 3%), agitated (n = 342, 1.8%), hypotension (n = 178, 0.9%), electrolyte disturbance (n = 153, 0.8%), coma (n = 156, 0.8%), and seizures (n = 121, 0.6%). There were 176 patients with a major effect of which 31 involved were children and 1728 (9%) patients with moderate effects of which 300 involved were children. Five deaths were reported in adults. Intentional exposure (e.g. suicide) was the reason for exposure in 68% of patients with major effects and in all fatalities. Fifty-three percent of adults and 38% of children were managed in a health-care facility (HCF). HCF utilization levels remained consistent.

DISCUSSION

Severe outcomes appear to be infrequent (<1%). Unlike other anticonvulsants OXC does not appear to be proconvulsant in overdose.

CONCLUSION

Serious outcomes for OXC overdoses are unlikely in the pediatric patient. With only mild symptoms likely, observation at home may be appropriate for the majority of cases. In the adult population there appears to be few neurologic and cardiovascular complications even in the intentional exposure.

Authors+Show Affiliations

Central Ohio Poison Center, Nationwide Children's Hospital, Columbus, OH, USA Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA haspiller5@gmail.com.Central Ohio Poison Center, Nationwide Children's Hospital, Columbus, OH, USA.Ball State University, Muncie, IN, USA.Nationwide Children's Hospital, Ohio State University, Columbus, OH, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26612556

Citation

Spiller, H A., et al. "Thirteen Years of Oxcarbazepine Exposures Reported to US Poison Centers: 2000 to 2012." Human & Experimental Toxicology, vol. 35, no. 10, 2016, pp. 1055-9.
Spiller HA, Strauch J, Essing-Spiller SJ, et al. Thirteen years of oxcarbazepine exposures reported to US poison centers: 2000 to 2012. Hum Exp Toxicol. 2016;35(10):1055-9.
Spiller, H. A., Strauch, J., Essing-Spiller, S. J., & Burns, G. (2016). Thirteen years of oxcarbazepine exposures reported to US poison centers: 2000 to 2012. Human & Experimental Toxicology, 35(10), 1055-9. https://doi.org/10.1177/0960327115618246
Spiller HA, et al. Thirteen Years of Oxcarbazepine Exposures Reported to US Poison Centers: 2000 to 2012. Hum Exp Toxicol. 2016;35(10):1055-9. PubMed PMID: 26612556.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Thirteen years of oxcarbazepine exposures reported to US poison centers: 2000 to 2012. AU - Spiller,H A, AU - Strauch,J, AU - Essing-Spiller,S J, AU - Burns,G, Y1 - 2015/11/26/ PY - 2015/11/28/entrez PY - 2015/11/28/pubmed PY - 2017/2/14/medline KW - Oxcarbazepine KW - anticonvulsant KW - poison center KW - poisoning KW - toxicity SP - 1055 EP - 9 JF - Human & experimental toxicology JO - Hum Exp Toxicol VL - 35 IS - 10 N2 - OBJECTIVES: Oxcarbazepine (OXC) is a 10-keto analogue of carbamazepine used in patients with partial and secondary generalized seizures. We evaluated ingestions of OXC reported to US poison centers for adverse effects from supratherapeutic doses and/or overdose. METHOD: Retrospective analysis of data reported to National Poison Data System from single-substance OXC ingestions between January 2000 and December 2012. RESULTS: There were 18,867cases with a mean of 1451 exposures/year. The patients were predominantly adults with 5464 exposures in children <6 years (29%). The most commonly reported clinical effects were drowsiness (n = 4703, 25%), vomiting (n = 1559, 8%), tachycardia (n = 590, 3%), agitated (n = 342, 1.8%), hypotension (n = 178, 0.9%), electrolyte disturbance (n = 153, 0.8%), coma (n = 156, 0.8%), and seizures (n = 121, 0.6%). There were 176 patients with a major effect of which 31 involved were children and 1728 (9%) patients with moderate effects of which 300 involved were children. Five deaths were reported in adults. Intentional exposure (e.g. suicide) was the reason for exposure in 68% of patients with major effects and in all fatalities. Fifty-three percent of adults and 38% of children were managed in a health-care facility (HCF). HCF utilization levels remained consistent. DISCUSSION: Severe outcomes appear to be infrequent (<1%). Unlike other anticonvulsants OXC does not appear to be proconvulsant in overdose. CONCLUSION: Serious outcomes for OXC overdoses are unlikely in the pediatric patient. With only mild symptoms likely, observation at home may be appropriate for the majority of cases. In the adult population there appears to be few neurologic and cardiovascular complications even in the intentional exposure. SN - 1477-0903 UR - https://wwww.unboundmedicine.com/medline/citation/26612556/Thirteen_years_of_oxcarbazepine_exposures_reported_to_US_poison_centers:_2000_to_2012_ DB - PRIME DP - Unbound Medicine ER -