A study on 24 allergic patients due to carbamazepine (1991- 1998) was performed at Bach mai Hospital. Results showed that: - The first signs of allergy appear late(11.37+4.56 days). - Main clinical symptoms of allergy are necrosis at natural cavities, erythema, fever. - The main clinical form of allergy is Stevens-Johnson syndrome (79.16%). - Elevated ESR, SGOT, SGPT are the main changes in tests. - It takes a long time to treat allergic patients due to carbamazepine (12.61+35days) - Glucocorticoid, dimedrol, glucose and ascorbic acid solution are the common medications.
Hypersensitivity ; carbamazepine

No abstract available.
Carbamazepine* ; Haloperidol*

Controlled-release carbamazepine (CBZ) could be more harmful than the regular form in special situations due to their respective biochemical characteristics. When primary treatment is not effective in acute intoxication, extracorporeal treatment (ECTR) could be an option. We recently applied ECTR to a patient with combined intoxication of topiramate and controlled-release CBZ who deteriorated despite receiving primary treatment. The patient improved after administering ECTR. Early ECTR intervention may be beneficial for the treatment of CBZ intoxication, especially of the controlled-release form.
Carbamazepine* ; Extracorporeal Circulation ; Humans

Electrical status epilepticus during sleep (ESES) is an electrographic pattern associated with specific genetic disorders, brain malformations, and use of some antiseizure medications. This case report aims to present the management of ESES in Sotos syndrome (SoS) on carbamazepine. A nine-year-old Filipino male with clinical features suggestive of overgrowth syndrome presented with febrile seizure at one year old. Cranial imaging showed cavum septum pellucidum, corpus callosal dysgenesis, and ventriculomegaly. He was on carbamazepine monotherapy starting at three years old. A near continuous diffuse spike–wave discharges in slow wave sleep was recorded at nine years old hence shifted to valproic acid. Follow-up study showed focal epileptiform discharges during sleep with disappearance of ESES. Next generation sequencing tested positive for rare nonsense mutation of nuclear receptor binding set-domain protein 1 confirming the diagnosis of SoS. Advanced molecular genetics contributed to determination of ESES etiologies. To date, this is the first documented case of SoS developing ESES. Whether an inherent genetic predisposition or drug-induced, we recommend the avoidance of carbamazepine and use of valproic acid as first-line therapy.
Sotos Syndrome ; Carbamazepine

No abstract available.
Carbamazepine ; Cataract ; Humans ; Young Adult

PURPOSE: To evaluate the efficacy of vigabatrin and valproic acid add-on therapy in the treatment of uncontrolled partial-onset seizures through randomized active controlled parallel-group trial. METHODS: Criteria for entry included a requirement for three or more partial seizures per month despite the blood level of carbamazepine was within therapeutic range. During the 56-day baseline period, patients had at least 6 partial onset seizures. Vigabatrin or valproic acid were administered as the second drug in a randomized fashion. RESULTS: Forty one patients completed the trial(21 for vigabatrin, 20 for valproic acid). There is no statistically significant difference in age, age at onset, baseline seizure frequency, dose of carbamazepine, and serum level of carbamazepine between two groups. Two patients of vigabatrin-treated group and three patients of valproic acid treated group were dropped out because of side effects. The mean vigabatrin and valproic acid does were 2809 and 1490 mg, respectively. The percentage of patients achieving at least a 50% reduction in seizure frequency at the end of 8-week of add-on trial was 62% among vigabatrin-treated patients and was 50% for patients who received valproic acid(not statistically different). There was no significant difference in seizure reduction, percent seizure reduction, and truncated percent seizure reduction between two groups. The side effects were mild and transient neurotoxic symptoms in the patients who completed the trial(5 patients for vigabatrin, 10 patients for valproic acid). CONCLUSIONS: This trial indicates that vigabatrin and valproic acid are safe and effective in the treatment of intractable partial-onset seizures. The efficacy of vigabatrin as a new add-on antiepileptic drug is comparable to the previous valproic acid carbamazepine combination in the sense of seizure reduction and maybe even superior to that in the consideration of side effects
Carbamazepine* ; Humans ; Seizures* ; Valproic Acid* ; Vigabatrin*

We evaluated the effect of carbamazepine-controlled release (CR) on the cognitive function. By using monotherapy study, we investigated the effects of carbamazepine on cognitive function in 10 epileptic patients and 17 normal controls. The evaluations were conducted before and one and six months after therapy using neuropsychological batteries(BUSCHKE SELECTIVE REMINDING TEST BSRT, REY OSTERRIETH COMPLEX FIGURE TEST ROCFT, CONCENTRATION ENDURANCE TEST d2 test, REY VISUAL DESIGN LEARNING TEST RVDLT, FINGER TAPPING TEST). In the patients treated with carbamazepine-CR monotherapy, follow up studies were made in one and six months later, respectively. It was found that the cognitive function determined in the three tests(consistent long-term retrieval : one item of BSRT, d2 test, and ROCFT : P 0.05). The mean anticonvulsant blood levels on the day of cognitive function tests were 6.48mg/ml (SD=l. 87) and 6.53mg /ml (SD=l.97) in one and six months respectively. This study showed carbamazepine-CR monotherapy had an adverse effect on the cognitive function.
Carbamazepine ; Fingers ; Follow-Up Studies ; Humans ; Learning

Compliance of epileptic patients is one of the most important factors for adequate therapy. Recently, it had been shown that the variability of three serial measurement of the serum levels of antiepileptic drug(AED) may be used as an indication of the degree of compliance. Coefficient variation(CV) of serum drug levels calculated by only one AED had been used to determine the compliance in epileptic patients who took multiple AEDs. We attempted to evaluate the CV of AEDs and then find the objective clue of compliance and the compatible therapeutic planing according to CV. Ninety seven epileptic patients of outpatients department of the Gyengsang National University Hospital were entered to this study. All patients were taking medication at least for 6 months without any changes of drug regimen. Patient's information was acquired by reviewing the chart and interview with questionnaire. With these informations, we determined the compliance of the patients. Antiepileptic serum levels were measured three times at intervals of at least two to four weeks apart, and their CV was calculated. We compared the CV between the compliant and non-compliant group in each AED(phenytoin, carbamazepine , valproic acid) and three drugs in the compliant group. The mean CVs of phenytoin, carbamazepine and valproic acid in the compliant group were 18.3+/-13.0, 15.2+/-10.2 and 23.8+/-8.9, respectively(mean+/-SD). The mean of CV in the compliant and the non-compliant group were 17.9+/-10.9 and 38.8+/-27.2, respectively. The CVs of the compliant group were significantly lower than those of the non-compliant group(p<0.05). However, CVs had no significant difference between three antiepileptic drugs. This study showed that CVs of AEDs were not different between each AEDs, even though they possess different pharmacokinetic properties. Therefore, the CV of one AED can be used in determining the compliance of the epileptics who are taking multiple AEDs.
Anticonvulsants ; Carbamazepine* ; Compliance ; Humans ; Outpatients ; Phenytoin* ; Surveys and Questionnaires ; Valproic Acid*

The relative bioavailability amd palsma level fluctuation of controlled release carbamazepine (carbamazepine CR, CBZ CR, Tegretol CR) to the regular product (Carbamazepine RR, CBZ RR, Tegletol RR) were studied in 12 patients who were taking stable dose of carbamazepine for more than six weeks. Fixed dosage regimen (400 mg every 12 hours) of both products was administered in a random cross over manner at least for four days. After reaching steady-state, serial blood samples were drawn after last dose administration. Plasma carbamazepine levels were analysed by fluorescence polarizing immunoassay. The controlled lelease products showed lower area under the concentration time curve (AUC; 89.7)20.0 ug/ml/hr) than that (107.1)13.2 ug/ml/hr) of the regular products (p<0.01), and also showed low peak plasma level (CR;848)l.93ug/ml, RR;10.57+1.55 ug/ml). However. Fluctuation of plasma drug level during dose interval was slightly less in controlled release products compared with carbamazepine regular products in the respect of various indices such as percent fluctuation, fluctuation index and area deviation from mean level. However those parameters did not show no statistical singificance between two products except area diviation (p<0.01). Though the controlled relase product showed slightly less fluctuation during dose interval, this seemed to be the expense of incomplete bioavailability. As a conclusion, the dose correction should be made according to the relative bioavailability of controlled release formulation if switching of the formulation from regular to controlled release form would be needed. However it could not be proved that controlled release fromulation had less fluctiuation during dose interval in this study. More detailed studies should be pursued to show the evidence of significant superiority of currently marketing controlled release formulation to the regular one.
Biological Availability* ; Carbamazepine* ; Fluorescence ; Humans ; Immunoassay ; Marketing ; Plasma

Although carbamazepine is being widely used in treatment of a variety of psychiatric disorders, it has some serious potential risks, including Stevens-johnson syndrome. Authors experienced in consultation a case of Stevens-johnson syndrome due to usage of carbamazepine. The patient was treated with carbamazepine to control for aggressive behavior after a hypoxic brain damage. Authors report a case of Stevens-johnson syndrome due to carbamazepine and also reviews related articles.
Brain Injuries* ; Brain* ; Carbamazepine* ; Humans ; Hypoxia, Brain ; Stevens-Johnson Syndrome*