Carbamazepine
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Carbamazepine Tic-like dyskineSia Case 1: A boy aged 8 years. with behavioural problems. developed tics of the face and shoulders when given dexamphetamine (dextroamphetamine) 5mg tid. The tics disappeared when treatment was discontinued EEG showed paroxysmal sharp and slow wave activity and independant right and left temporal sharp waves. After 6 weeks of treatment with carbamazepine 700 mg/day, he developed tic-like shoulder movements,phonic tics and myoclonic body movements which subsided when treatment was stopped. Case 2: A 9-year-old boy, with behavioural problems. developed tics of the face and right arm when given methylphenidate 7.5mg tid. and tics of the face when given desipramine SOmg bid. EEG showed right temporal-lobe spikes Atter 1 weeks' treatment with carbamazepine 200mg bid. he developed tic-like movements ot the right arm and shoUlder which subsided when treatment was stopped. Tic-like dyskinesias caused by stimulants and the tricyclic antidepressants are usually attributed to the noradrenergic and/or dopaminergic activity of these 2 classes of drugs. Carbamazepine is known to block noradrenaline [norepinephrine] re-uptake and to increase acetylcholine levels. These factors would probably account for carbamazepine's ability to preCipitate dyskinetic movements. Guall,efI. C T and Evans. R. W. Developmental MediCI"" .. nd C/lIld Neurology 26 546 (Aug 1984) 0157-7271/84/1110.()()()5/0$O1.00/0 @ ADIS Press Reactions 10 NOli 1984 5
Transcript of Carbamazepine
Carbamazepine Tic-like dyskineSia
Case 1: A boy aged 8 years. with behavioural problems. developed tics of the face and shoulders when given
dexamphetamine (dextroamphetamine) 5mg tid. The tics disappeared when treatment was discontinued EEG showed paroxysmal sharp and slow wave activity and independant right and left temporal sharp waves. After 6 weeks of treatment with carbamazepine 700 mg/day, he developed tic-like shoulder movements,phonic tics and myoclonic body movements which subsided when treatment was stopped.
Case 2: A 9-year-old boy, with behavioural problems. developed tics of the face and right arm when given methylphenidate 7.5mg tid. and tics of the face when given desipramine SOmg bid. EEG showed right temporal-lobe spikes Atter 1 weeks' treatment with carbamazepine 200mg bid. he developed tic-like movements ot the right arm and shoUlder which subsided when treatment was stopped. Tic-like dyskinesias caused by stimulants and the tricyclic antidepressants are usually attributed to the noradrenergic and/or dopaminergic activity of these 2 classes of drugs. Carbamazepine is known to block noradrenaline [norepinephrine] re-uptake and to increase acetylcholine levels. These factors would probably account for carbamazepine's ability to preCipitate dyskinetic movements. Guall,efI. C T and Evans. R. W. Developmental MediCI"" .. nd C/lIld Neurology 26 546 (Aug 1984)
0157-7271/84/1110.()()()5/0$O1.00/0 @ ADIS Press Reactions 10 NOli 1984 5
