Carbamazepine as a single drug in the treatment of epilepsy. A prospective study of serum levels and seizure control.

Callaghan, N.; O’Callaghan, Michael; Duggan, B.; Feely, M.

doi:10.1136/jnnp.41.10.907

Cited by 69 publications

(14 citation statements)

References 14 publications

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“…With CSF levels ranging from 17-31% of the plasma level, the CSF concentrations are between 3 and 16 pM (31). These values have to be also evaluated in view of the problems to correlate serum levels of carbamazepine and clinical effects (36).…”

Section: Discussionmentioning

confidence: 99%

Phenytoin, phenobarbital, and midazolam fail to stop status epilepticus-like activity induced by low magnesium in rat entorhinal slices, but can prevent its development

Dreier

Zhang

Heinemann

1998

Acta Neurologica Scandinavica

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It was shown previously that low-Mg2+-induced epileptiform activity in rat entorhinal cortex slices changes with time from a pattern of serial seizure-like events (SLEs) to a state of continuously recurring epileptiform activity. Valproic acid blocked the early SLEs but not the late activity. It was proposed that the late activity is a model for pharmacoresistant status epilepticus since it was also refractory to phenytoin, carbamazepine, phenobarbital, and midazolam. In the present study, it is demonstrated that phenytoin (50 microM, n=6), phenobarbital (150 microM, n=7), and midazolam (50 microM, n=5) were able to block the early SLEs but not the late activity at the same concentrations. Carbamazepine (50 microM) reduced the duration of the SLEs from 21 +/-5 s to 4+/-3 s (P<0.01), the interictal interval from 123+/-27 s to 27+/-19 s (P<0.01), the SLE-associated rise of [K+]o from 7.7+/-0.5 mM to 5.7+/-0.8 mM (n=4, P<0.05), and the spread of the SLE between entorhinal cortex and neocortex from 4.0+/-0.6 s to 0.8+/-0.1 s (n=4, P<0.05). Lower concentrations of phenytoin (5 and 10 microM, n=5), carbamazepine (10 microM, n =6), and phenobarbital (50 microM, n = 4) had no effect. In conclusion, the hypothesis is supported that low-Mg2+-induced epileptiform activity in rat entorhinal cortex is an in vitro model for the transition from pharmacosensitive to pharmacoresistant status epilepticus.

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Section: Discussionmentioning

confidence: 99%

Phenytoin, phenobarbital, and midazolam fail to stop status epilepticus-like activity induced by low magnesium in rat entorhinal slices, but can prevent its development

Dreier

Zhang

Heinemann

1998

Acta Neurologica Scandinavica

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“…The metabolism of CBZ occurs in the liver via a firstorder process. The drug's half-life, after single oral doses in healthy volunteers, was found to be approximately 40 h (8,11,12). In epileptic patients taking the drug chronically, the elimination half-life is shorter (7, 8), by the daily doses given (Fig.…”

Section: Discussionmentioning

confidence: 99%

Estimation of population pharmacokinetics for carbamazepine in Malaysian patients using the OPT® computer program

Ismail

Rahman

1993

J Clin Pharm Ther

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We used OPT to estimate individual and population pharmacokinetics for carbamazepine (CBZ) in Malaysian epileptic patients attending our Neurology Clinic. We noted that plasma CBZ concentrations and clearances correlated poorly with daily doses and body weights respectively but we found the values for clearance, volumes of distribution, elimination rate constants and half lives to be in good agreement with earlier reports. We conclude that OPT is a simple yet useful program to derive individual and population pharmacokinetic parameters for CBZ for use in dosage adjustments. We also conclude that although the Malaysian population do not differ substantially in handling CBZ, available data for the pharmacokinetic parameters must be used cautiously in applying it to the therapeutic drug monitoring for CBZ in our patients.

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“…CBZ has been reported to be effective in monotherapy for partial and generalized tonic-clonic seizures in one third to one half (Scheffner et al, 1972;Callaghan et al, 1978) or in 62438% (Shorvon et al, 1978;Schmidt et al, 1983) of patients, including children (Sato et al, 1979;Johnston et al, 1981;Scarpa et al, 1982). Rodin et al (1974) reported that CBZ reduced the frequency of psychomotor seizures by 83% and of grand mal seizures by 55%.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical outcome is most favorable with monotherapy. There are a few reports on CBZ therapy and longterm follow-up data in children (Scheffner et al, 1972;Schain et al, 1977;Callaghan et al, 1978;Sat0 et al, 1979;Scarpa et al, 1982). This is a report of long-term prognosis in children with partial or generalized TCS with or without focal paroxysms on the electroencephalogram (EEG).…”

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confidence: 99%

Carbamazepine Therapy and LongTerm Prognosis in Epilepsy of Childhood

et al. 1989

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Sixty-seven of 90 patients (74% who had been treated with carbamazepine (CBZ) alone were seizure-free for greater than 3 years. The EEG of the patients given CBZ monotherapy was more often normal in those without neurologic abnormalities other than mental retardation or a genetic predisposition. The prognosis of patients with partial seizures secondarily generalized was poorer than that of the other patients. Patients without mental retardation more often had monotherapy CBZ. The lowest blood level of CBZ for maintenance was considered to be 4 micrograms/ml, although the therapeutic blood level was between 6 and 12 micrograms/ml. Most of the side effects were mild.

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Carbamazepine as a single drug in the treatment of epilepsy. A prospective study of serum levels and seizure control.

Cited by 69 publications

References 14 publications

Phenytoin, phenobarbital, and midazolam fail to stop status epilepticus-like activity induced by low magnesium in rat entorhinal slices, but can prevent its development

Phenytoin, phenobarbital, and midazolam fail to stop status epilepticus-like activity induced by low magnesium in rat entorhinal slices, but can prevent its development

Estimation of population pharmacokinetics for carbamazepine in Malaysian patients using the OPT® computer program

Carbamazepine Therapy and LongTerm Prognosis in Epilepsy of Childhood

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