Overnight transition from carbamazepine to oxcarbazepine in children and adolescents

Study Objective. To evaluate our clinical experience in pediatric patients who were rapidly switched from carbamazepine to oxcarbazepine at full therapeutic doses. Design. Retrospective medical record review. Setting. Children's hospital. Patients. Twenty six patients (mean age 9.8 yrs, range 5-21 yrs) with childhood epilepsy who were converted from carbamazepine to oxcarbazepine overnight between January 2003 and December 2005. Measurements and Main Results. Data collection included patient demographics, seizure type, epilepsy syndrome, seizure frequency, and adverse events. Dose conversion ratios for switching from carbamazepine to oxcarbazepine ranged from 1:1-1.5. The transition was well tolerated, with only three patients experiencing an adverse event (rash). Among the other 23 patients, seizure frequency decreased in 12 (52%), increased in two (9%), and remained unchanged in nine (39%). Conclusion. Overnight switching from carbamazepine to oxcarbazepine may be a useful option for pediatric patients who cannot tolerate or whose condition is unresponsive to carbamazepine.