Massive Lindane Overdose with Toxicokinetics Analysis

Abstract

Background Lindane is a possible carcinogen with known teratogenicity and immunologic and neurotoxic properties. Despite reports of seizures, coma, and death associated with its use as well as banning of its environmental use by the Environmental Protection Agency (EPA), the US Food and Drug Administration (FDA) still allows treatment with lindane as a second-line scabicide and pediculicide. We present a case of a massive suicidal ingestion of lindane in which the patient survived the ingestion, though he did expire shortly thereafter from an unrelated cause pre-discharge. Methods Pharmacokinetic analysis of serum lindane concentrations was performed with Phoenix® WinNONLIN®. The estimated distribution half-life for lindane was 10.3 h, and the terminal half-life was 162.9 h, much longer than the previously reported terminal half-life of 25-36 h. Because of this long half-life, repeated lindane exposures may lead to accumulation of lindane in the tissues.Result After overdose, toxicity may be delayed and full recovery may be prolonged.

The effects of hydrogen sulfide synthesis inhibition in lindane-induced seizures in rats: A behavioral and EEG study

“…There are many different mechanisms, such as blockage of GABAA receptors [4], which could explain the convulsive effect of lindane, but they are not fully understood. On the other hand, it has been proven that H2S mitigates damage to the hippocampus by preventing the loss of GABAB receptors during recurrent febrile seizures [18,19]. In this manner, H2S can achieve a balance between excitation and inhibition during seizures, facilitating the occurrence of hyperpolarization.…”

Pollutants, including Organophosphorus and Organochloride Pesticides, May Increase the Risk of Cardiac Remodeling and Atrial Fibrillation: A Narrative Review

“…In mice, PCB administration was associated with cardiac hypertrophy and abnormal blood pressure [ 86 ]. A Clinical report suggested that lindane ingestion (accidental or intentional) was associated with the occurrence of atrial fibrillation and flutter [ 87 ]. A study of the frog atrium suggests that lindane-associated rhythm disorder may reside in the fact that lindane increases rapid delayed outward K + currents which provokes action potential repolarization in the atria [ 88 ].…”