COMBINATION VALPROATE CARBAMAZEPINE THERAPY IN PARTIAL EPILEPSIES RESISTANT TO CARBAMAZEPINE MONOTHERAPY

被引:17
|
作者
HARDEN, CL
ZISFEIN, J
ATOSRADZION, EC
TUCHMAN, AJ
机构
[1] NEW YORK MED COLL,LINCOLN HOSP,BRONX,NY
[2] CORNELL UNIV,MED CTR,NEW YORK,NY 10021
来源
JOURNAL OF EPILEPSY | 1993年 / 6卷 / 02期
关键词
VALPROATE; CARBAMAZEPINE; SEIZURES; TOXICITY;
D O I
10.1016/S0896-6974(05)80094-5
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Eighteen patients with poorly controlled partial epilepsy on carbamazepine monotherapy at maximum tolerated doses were treated with valproate adjunctive therapy. Both medications were maintained for at least 3 months at the highest tolerated doses. Three patients had >50% decrease in seizure frequency on bitherapy; six patients were moderately improved, with a 22-44% decrease in seizure frequency; the remaining nine patients were unchanged or worsened, with up to a 49% increase in seizure frequency. Five of six patients with more than four seizures per month improved on bitherapy. Four patients had a shift of predominant seizure type from tonic-clonic to complex partial; two of these patients were moderately improved and two had an overall increase in seizures. Clinical toxicity was common on bitherapy, managed by a reduction in carbamazepine dose in most patients. We conclude that valproate-carbamazepine bitherapy may be beneficial in approximately half of patients who have failed high-dose carbamazepine monotherapy; however, marked improvement is infrequent. Valproate-carbamazepine bitherapy is also frequently associated with clinical anticonvulsant toxicity at the beginning of bitherapy, but this is generally easily managed with medication adjustment.
引用
收藏
页码:91 / 94
页数:4
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