Marini Ann M, Choi John Y, Labutta Robert J
Department of Neurology and Neuroscience, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
Clin Neuropharmacol. 2003 Jul-Aug;26(4):174-6. doi: 10.1097/00002826-200307000-00003.
Carbamazepine is a well-established, effective treatment of complex partial seizures and is well tolerated in most patients. The adverse effects of carbamazepine include aplastic anemia, agranulocytosis, pancytopenia, bone marrow depression, thrombocytopenia, cardiac conduction abnormalities, congestive heart failure, and peripheral edema. Hypertension or hypotension has also rarely been documented in patients with either therapeutic or toxic blood levels of carbamazepine. It is possible that carbamazepine-induced hypertension in those with therapeutic blood levels is rarely seen because most of the patients who begin treatment are young and do not have baseline hypertension. The authors describe a patient of African-American descent with a history of controlled essential hypertension who developed severe uncontrolled hypertension when started on carbamazepine. Treatment with additional antihypertensive medications did not reduce his blood pressure. In addition, he developed two episodes of transient neurologic deficits, the symptoms of which consisted of dysarthria, vertigo, and unstable gait. A substantial reduction of his carbamazepine dose resulted in the control of his blood pressure and no recurrence of his symptoms.
卡马西平是一种公认的、治疗复杂部分性癫痫有效的药物，大多数患者对其耐受性良好。卡马西平的不良反应包括再生障碍性贫血、粒细胞缺乏症、全血细胞减少、骨髓抑制、血小板减少、心脏传导异常、充血性心力衰竭和外周水肿。卡马西平治疗剂量或中毒剂量的患者中也很少有高血压或低血压的记录。治疗剂量的卡马西平引起高血压很少见，可能是因为开始治疗的大多数患者都很年轻，且没有原发性高血压的基线。作者描述了一名有原发性高血压控制史的非裔美国患者，在开始服用卡马西平后出现了严重的、无法控制的高血压。加用其他抗高血压药物治疗并不能降低他的血压。此外，他出现了两次短暂性神经功能缺损发作，症状包括构音障碍、眩晕和步态不稳。大幅减少他的卡马西平剂量后，他的血压得到了控制，症状也未复发。
