Charcoal hemoperfusion for treatment of carbamazepine poisoning.

We report a case of carbamazepine (Tegretol) poisoning that was treated with charcoal hemoperfusion. When admitted, the patient was comatose and required ventilatory support. Hemoperfusion with coated activated charcoal successfully decreased her serum carbamazepine concentration from 60 mg/L to 36 mg/L within 2 h, with subsequent clinical improvement. Approximately 39 h would have been required to obtain this decrease via the patient's inherent elimination rate. Activated charcoal hemoperfusion may be useful as an adjunctive therapy for patients in advanced comatose states with associated respiratory depression and potentially fatal outcome.