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Overdose: Mild to moderate toxicity: The signs and symptoms of an acute overdose are expected to be similar to adverse effects seen at therapeutic doses. Dizziness, nausea, and seizures (generalized tonic-clonic seizures, status epilepticus) have been reported with lacosamide ingestions of more than 800 mg (twice the maximum recommended daily dosage).
Severe toxicity: Cardiac conduction disorders, confusion, QRS prolongation, AV blocks, cardiogenic shock, and cardiac arrest have been reported.
Treatment: Treatment is symptomatic and supportive. Patients may require airway management. Closely monitor neurologic function. Treat QRS prolongation with sodium bicarbonate; an initial dose of 1 to 2 mEq/kg is reasonable. Monitor ECG and arterial blood gases.
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