CARDIOVASCULAR EFFECTS OF CARBAMAZEPINE TOXICITY

Study objective: To evaluate the cardiovascular effects of carbamazepi ne in patients presenting to the emergency department. Design: A retro spective case series from February 1, 1985, to July 30, 1993. Setting: Six urban EDs. Participants: Seventy-two adult and pediatric patients with serum carbamazepine concentrations greater than 12 mu g/mL and c oncurrent 12-lead ECGs. Results: The mean carbamazepine level was 24 m u g/mL (range, 12.6 to 55 mu g/mL). Minor ECG abnormalities were noted but no clinically significant arrhythmias were found. No correlation was found between carbamazepine concentration and heart rate or PR, QR S, or corrected QT intervals. Four adult patients had transient hypote nsion. Conclusion: Clinically significant cardiovascular toxicity occu rs rarely in patients with toxic carbamazepine concentrations. ECG fin dings do not correlate with serum carbamazepine concentration.