Factors associated with nonbenzodiazepine antiepileptic drug intoxication: Analysis of 9,809 registered cases of drug poisoning

Abstract

Antiepileptic drug (AED) intoxications are common due in part to wide clinical application and availability. Because AEDs usually depress central nervous system function, overdosing may be potentially life-threatening or lead to a range of adverse outcomes. The aim of this study was to identify risk factors for nonbenzodiazepine AED (NBAED) intoxication. In this cross-sectional study, all consecutive adult and adolescent (>12 years old) poisoned patients who presented to the Loghman-Hakim Poison Hospital (LHPH) during a 6-month period were evaluated. Patients with NBAED intoxication were identified and compared to a control group of those other pharmaceutical intoxications. The risk factors for AED intoxication were identified using univariate analyses and multivariate modeling. Among 9,809 cases of pharmaceutical agent overdose, there were 474 cases (4.8%) with NBAED intoxication. Mean age of the subjects was 24.5 +/- 8.9 years. The most frequent NBAED was carbamazepine (n = 117), followed by phenobarbital (n = 77) and sodium valproate (n = 51). The most frequent motivation was intentional intoxication (95.3%). Multivariate analysis revealed that presence of medical disorders, a history of psychological events, and loneliness were associated with AED intoxication, whereas educational level had a protective effect. There was no association between previous history of parasuicide, sex, age, occupation status, and AED intoxication. In conclusion, this study showed that the majority of AED intoxications are due to deliberate self poisoning. The presence of psychological events, medical disorders, and loneliness are risk factors for AED intoxication, whereas higher education level has a protective effect.