Thirty pediatric cases of carbamazepine overdoses were reviewed retros
pectively for the frequency of toxic effects. Patients were divided in
to three groups, depending on the type of overdose: acute, acute-on-ch
ronic, and chronic. Effects included lethargy in 93%, ataxia in 50%, n
ystagmus in 13%, and minor arrhythmias in 10%. Major effects included
seizures in 20%, coma in 27%, and need for intubation in 20%. Higher s
erum carbamazepine levels were associated with these major effects in
the acute and acute-on-chronic groups but not in the chronic group. Se
rum levels greater than 35 mg/L (147 mumol/L), were significantly asso
ciated with major toxicities.