Asian Journal of Case Reports in Medicine and Health

Phenobarbitone poisoning remains a clinically significant condition due to its prolonged half-life, narrow therapeutic index, and risk of severe systemic complications. We report the case of a 21-year-old female who presented with altered sensorium following an intentional overdose of phenobarbitone (30 tablets of 60 mg each; total 1.8 g). On admission, her Glasgow Coma Scale (GCS) score was 8/15. She was managed in the ICU with airway protection, gastric lavage, activated charcoal, forced alkaline diuresis, and supportive care. Due to persistent central nervous system depression, charcoal hemoperfusion was performed, resulting in neurological improvement (GCS = 15/15). During her hospital stay, pneumonia developed after gastric lavage and was successfully treated with antibiotics. The patient made a complete clinical recovery and was discharged with advice for psychiatric follow-up. This case highlights the importance of early recognition, intensive supportive care, and vigilance for secondary complications, such as pneumonia, in phenobarbitone poisoning.