Carbamazepine
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Carbamazepine Somnolence Ataxia and severe somnolence developed in a 19-month-old boy who had received carbamazepine 100mg qid for 2 weeks. During this period, the boy had also been given 'Actifed ' (pseudoephedrine hydrochloride 30 mg/ 5ml and triprolidine hydrochloride 125 mg/ 5ml) 5ml tid for 3 days plus 1 dose on the morning he attended hospital. On examinati on the child had a blood glucose concentration of 4.8 mmol/L, serum calcium concentratin of 2. 63 mmolfL, serum magnesium level of o 96 mmol/L and a serum carbamazepine concentration (20 mg/L) above the therapeutic range (3-13 mgj L) . The child was discharged on carbamazepine 100mg tid . However . 3 days later th e child was still experiencing severe somnolence. During investigation, the child was given oral carbamazepi ne 100mg and within 20 min he was asleep (serum carbamazepine level 8 mg/L). The child remained asleep for B hours . Subsequently carbamazepine was withdrawn and the child has remained well. Levy. A. . Chong. SKF. and Pri ce . J.F .. Lancet 2: 221- 222 (21 Jul 1985) Stevens-Johnson syndrome Three weeks after commencing treatment 01 bipolar affective disorder with carbamazepine (initially 200mg bid, increased to 200mg tid after 1 week), a 59-year - Old man complained of a sore throat and a body rash . Examination showed sev ere stomatitis and a generalised maculopapular rash , both with vesicles. However, Nikolsky's sign was negative. Bilateral conjunctivitis with a clear discharge was also noted. His serum carbamazepine JeveJ was 7 p.g/ml. Carbamazepine was replaced with lithium, and a tapering course of oral and ophthalmic steroids initiated. The symptoms resolved, and the patient was discharged after 5 days. Thus, caution is required in the use of carbamazepine. Pa tterson. J.F.: Journal of Clinical Psychopharmacology 5: 185 (Jun 1985)
Transcript of Carbamazepine
Carbamazepine Somnolence
Ataxia and severe somnolence developed in a 19-month-old boy who had received carbamazepine 100mg qid for 2 weeks. During this period, the boy had also been given 'Actifed ' (pseudoephedrine hydrochloride 30 mg/5ml and triprolidine hydrochloride 125 mg/5ml) 5ml tid for 3 days plus 1 dose on the morning he attended hospital. On examination the child had a blood glucose concentration of 4.8 mmol/L, serum calcium concentratin of 2.63 mmolfL, serum magnesium level of o 96 mmol/L and a serum carbamazepine concentration (20 mg/L) above the therapeutic range (3-13 mgj L) . The child was discharged on carbamazepine 100mg tid .
However . 3 days later the child was still experiencing severe somnolence. During investigation , the child was given oral carbamazepine 100mg and within 20 min he was asleep (serum carbamazepine level 8 mg/L). The child remained asleep for B hours . Subsequently carbamazepine was withdrawn and the child has remained well. Levy. A. . Chong. SKF. and Price. J.F .. Lancet 2: 221-222 (21 Jul 1985)
Stevens-Johnson syndrome Three weeks after commencing
treatment 01 bipolar affective disorder with carbamazepine (initially 200mg bid, increased to 200mg tid after 1 week), a 59-year-Old man complained of a sore throat and a body rash . Examination showed severe stomatitis and a generalised maculopapular rash , both with vesicles. However, Nikolsky's sign was negative. Bilateral conjunctivitis with a clear discharge was also noted. His serum carbamazepine JeveJ was 7 p.g/ml.
Carbamazepine was replaced with lithium, and a tapering course of oral and ophthalmic steroids initiated. The symptoms resolved, and the patient was discharged after 5 days.
Thus, caution is required in the use of carbamazepine.
Patterson. J.F.: Journal of Clinical Psychopharmacology 5: 185 (Jun 1985)
