Case Report Failure of Ketamine Anesthesia in a Patient with Lamotrigine Overdose

Copyright © 2014 D. Kornhall and E. W. Nielsen. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. It is important to know which clinical situations prevent ketamine from working. Case Report. We present the case of the psychiatric inpatient who was admitted to our emergency department after ingesting a toxic dose of lamotrigine, unknown at that time. On admission, she was clearly in distress, displaying extreme agitation and violent ataxic movements. We opted to achieve sedation using intravenous ketamine boluses. Unexpectedly, after being injectedwith a total of 250mg ketamine, our patient displayed no signs of dissociative anaesthesia.Discussion.There was no apparent reason for why ketamine failed, but an interactio