Luszczki Jarogniew J, Borowicz Kinga K, Swiader Mariusz, Czuczwar Stanislaw J
Department of Pathophysiology, Medical University, Jaczewskiego, Lublin, Poland.
Epilepsia. 2003 Apr;44(4):489-99. doi: 10.1046/j.1528-1157.2003.32702.x.
The aim of this study was to determine the types of interactions between oxcarbazepine (OCBZ) and conventional antiepileptic drugs (AEDs) against maximal electroshock-induced seizures (MES test) in mice, by using a method of isobolographic analysis.
Adverse effects of combinations were evaluated in the chimney test (motor performance), also using the isobolographic method, which allowed determination of the median toxic dose (TD50) values for individual combinations; thus the protective indices could be determined.
OCBZ and phenytoin (PHT) at the fixed-ratio combination of 1:1 were significantly infraadditive (antagonistic) with respect to the antiseizure protection against MES and simultaneously additive in terms of side effects in the chimney test. Interestingly, combinations between OCBZ and clonazepam (CZP) in the MES test proved antagonistic or synergistic, depending on the proportion of both AEDs in the mixture. Low doses of OCBZ with high doses of CZP exerted antagonism. Conversely, high doses of OCBZ combined with low doses of CZP resulted in a synergistic interaction. Remaining combinations between OCBZ and phenobarbital, valproate, or carbamazepine were purely additive, either as regards the anticonvulsant activity against MES or in terms of motor impairment in the chimney test.
The results of this study indicate that interaction of OCBZ and CZP at fixed-ratio combination of 1:1 might be profitable from a clinical point of view. Conversely, combinations of OCBZ with PHT may not be clinically efficient.
本研究旨在通过采用等效应线图分析法,确定奥卡西平(OCBZ)与传统抗癫痫药物(AEDs)联合使用时,针对小鼠最大电休克诱导惊厥(MES试验)的相互作用类型。
采用等效应线图法,在烟囱试验(运动性能)中评估联合用药的不良反应,从而确定各个联合用药的半数中毒剂量(TD50)值;进而确定保护指数。
在针对MES的抗惊厥保护方面,OCBZ与苯妥英(PHT)按1:1固定比例联合使用时显著低于相加效应(拮抗),而在烟囱试验中的副作用方面则为相加效应。有趣的是,在MES试验中,OCBZ与氯硝西泮(CZP)的联合使用根据混合物中两种AEDs的比例显示出拮抗或协同作用。低剂量OCBZ与高剂量CZP联合产生拮抗作用。相反,高剂量OCBZ与低剂量CZP联合则产生协同相互作用。OCBZ与苯巴比妥、丙戊酸盐或卡马西平的其余联合使用,无论是在针对MES的抗惊厥活性方面,还是在烟囱试验中的运动功能损害方面,均表现为纯粹的相加效应。
本研究结果表明,从临床角度来看,OCBZ与CZP按1:1固定比例联合使用可能有益。相反,OCBZ与PHT联合在临床上可能效果不佳。