Assessment of the pattern, severity, and outcomes of acute mood stabilizer drug poisoning

Abstract

BACKGROUND: Mood-stabilizer drugs are associated with a considerable incidence of morbidity and mortality. AIM: This study aimed to assess the pattern, severity, and outcomes of poisoning with acute mood stabilizer drugs among admitted patients to Tanta University Poison Control Center, Egypt between January 2021 and September 2023. PATIENTS AND METHODS: This cross-sectional study was conducted in patients with acute mood stabilizer drug poisoning. Data from electronic medical records were observed. The poison severity score (PSS) assessed the severity of the patients. Primary outcomes were the pattern and severity assessment. Secondary outcomes included the incidence of mortality, the need for intensive care unit (ICU) admission, the need for intubation and mechanical ventilation, the incidence of complications, and the duration of hospital stay. RESULTS: A total of 67 patients with acute poisoning of mood stabilizers were included. Poisoning with carbamazepine accounted for 58.2% of all mood stabilizers, followed by valproic acid (29.8%), lithium (7.5%), and lamotrigine (4.5%). The highest proportion of patients were young, females, with intentional poisoning and were classified as mild to moderate poisoning based on PSS. There were significant statistical associations between PSS and the need for ICU admission, development of complications, and length of hospital stay among poisoned patients with carbamazepine or valproic acid. CONCLUSIONS: Carbamazepine poisoning and valproic acid poisoning were the most common mood stabilizers compared to lithium and lamotrigine poisoning. In acute carbamazepine and valproic acid poisoning, the PSS is a relevant score that could predict the need for ICU admission, the development of complications, and the duration of hospital stays.