Carbamazepine
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Carbamazepine Behavioural changes In a survey conducted to determine parental attitudes towards drug administration to their children with epilepsy, it became apparent that several children receiving carbamazepine showed bizarre behavioural episodes. 200 epileptic children treated with carbamazepine were subsequently reviewed at a paediatric neurology clinic and 7 of them showed acute adverse behavioural changes. Most had difficulty in sleeping and several had difficulty in thinking cleady. In 3 patients, each of whom was mentally retarded, the symptoms were particularly alarming and dramatic: one had developmental regression and irritability; another had psychotic features; and the last had delirium. It would thus appear that the reactions are more common in patients with pre-existing CNS problems. Carbamazepine concentrations were not in the toxic range. Tbe symptoms usually occurred after first instituting the drug or after suddenly increasing the dose. Lowering the dose or drug withdrawal led to a rapid resolution in symptoms. Five of the 7 patients were eventually able to tolerate the drug when it was slowly reintroduced indicating that a previous adverse behavioural reaction is not an absolute contraindication to use. Recognition of the symptoms of this carbamazepine adverse reaction is important, otherwise extensive diagnostic evaluation for other causes of encephalopathy might be pursued. Silvers!.in, FS, eE al.: Journal of Pediatrics tOl: 785 (Nov 1982) 4 Reactions 10 Dec 1982 0157-7271/82/1210·0004/0$01,0010 @ ADIS!'ress
Transcript of Carbamazepine
Carbamazepine
Behavioural changes In a survey conducted to determine parental attitudes towards drug administration to their children with epilepsy, it became apparent that several children receiving carbamazepine showed bizarre behavioural episodes. 200 epileptic children treated with carbamazepine were subsequently reviewed at a paediatric neurology clinic and 7 of them showed acute adverse behavioural changes. Most had difficulty in sleeping and several had difficulty in thinking cleady. In 3 patients, each of whom was mentally retarded, the symptoms were particularly alarming and dramatic: one had developmental regression and irritability; another had psychotic features; and the last had delirium. It would thus appear that the reactions are more common in patients with pre-existing CNS problems. Carbamazepine concentrations were not in the toxic range. Tbe symptoms usually occurred after first instituting the drug or after suddenly increasing the dose. Lowering the dose or drug withdrawal led to a rapid resolution in symptoms. Five of the 7 patients were eventually able to tolerate the drug when it was slowly reintroduced indicating that a previous adverse behavioural reaction is not an absolute contraindication to use. Recognition of the symptoms of this carbamazepine adverse reaction is important, otherwise extensive diagnostic evaluation for other causes of encephalopathy might be pursued. Silvers!.in, FS, eE al.: Journal of Pediatrics tOl: 785 (Nov 1982)
4 Reactions 10 Dec 1982 0157-7271/82/1210·0004/0$01,0010 @ ADIS!'ress
