Carbamazepine has been successfully employed in a variety of neurological and psychiatric disorders. Carbamazepine poisoning can be life threatening.
We describe the use of multiple doses activated charcoal in an 18-year-old female who developed coma due to an intentional carbamazepine overdose (peak drug level of 37.14 mcg/ml ; therapeutic range: 8-12 mcg/ml). Without intervention, the half-life of drug elimination is 25 to 60 hours in patients who are naive to carbamazepine 12 to 20 hours in adolescence on chronic carbamazepine therapy. The patient recovered rapidly and was discharged from hospital 3 days from the time of ingestion with no complications or neurologic impairment. Because the cost-benefit analysis was also favorable relative to other therapeutic options, multiple doses activated charcoal may be optimal treatment of toxic level (drug level below 40 mcg/ml) ingestion of carbamazepine.