CASE REPORT Tiagabine Overdose: A Case of Status Epilepticus in a Non-Epileptic Patient

Tiagabine is an antiepileptic drug used as adjunctive therapy for partial seizures that is believed to selectively inhibit the presynaptic reuptake of gamma aminobutyric acid (GABA). We describe a case of a tiagabine overdose that resulted in status epilepticus (SE) in a patient with no seizure history. A 14-year-old girl with a history of asthma presented with convulsive SE after ingestion of an unknown amount of her sister’s tiagabine in a suicide attempt. Attempted anticonvulsant therapy included a total of diazepam 10 mg IV, lorazepam 6 mg IV, pyridoxine 5 g IV, and fosphenytoin 20 mg PE/kg. All were without effect. A computed tomography and electrocardiogram were normal. Con-tinuous bedside EEG monitoring showed suppression of seizure activity following intravenous midazolam. A tiagabine level ob-tained on ED arrival was 420 ng/mL (therapeutic 20–103 ng/mL). The patient was discharged to psychiatry within 1 week with no neurologic sequelae