Memantin HCL (
Ebixa) is a
drug which antagonizes the effects of N-methyl-D-aspartat receptors and which is used for the treatment of acute Alzheimer patients.
Plasmapheresis is a method of cleaning nonspecific extracorporeal blood and it is applied in many immunologic and toxicologic diseases. Female patient at the age of 35 was admitted to the emergency department with complaints of tendency to sleep and sensory loss. About 12 hours before her history she had taken 200
tablets of 10 mg
memantin HCL (
Ebixa) (2000 mg) and she was transferred to an
intensive care department with the diagnosis of
drug toxicity (400 mg toxic dose). Her
memantin HCL (
Ebixa) level in blood was 12,000 ng/mL. It was reported in her physical examination that she was unconscious, her general condition was bad, there were no cooperation and orientation, ahe hadmydriasis and reflexes of light, cornea and eyelash were bilaterally positive and she had
horizontal nystagmus. Glascow
Coma Scale of the patient was 6, body temperature was 37.5 degrees C and she had
tachycardia (130/min) and
hypertension (160/90 mmHg). Intravenous
Diazepam was effective aginst recurring convulsions. Sinusoidal
tachycardia was detected with electrocardiography (EKG) and
respiratory alkalosis in arterial blood
gases. Six cysles of
plasmapheresis were aplied and in the sixth cycle the
memantin HCL (
Ebixa) level turned to normal. As a result of the sixth
plasmapheresis the findings were normal and that is why she was discharged from the hospital.
Plasmapheresis should be taken into consideration in case of
drug overdose or high doses of plasmatic proteinous
drug toxicities (Ref. 11).