Zifkin B, Sherwin A, Andermann F
Département des Sciences Neurologiques, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, PQ, Canada.
Neurology. 1991 Feb;41(2 ( Pt 1)):313-4. doi: 10.1212/wnl.41.2_part_1.313.
The benzodiazepine antiepileptic drug clobazam can be added to existing AED treatment, usually without clinical toxicity. We report 3 patients in whom the addition of clobazam led within several weeks to clinically obvious phenytoin (PHT) intoxication in patients who had been taking maximum tolerable PHT doses. Symptoms and high PHT levels resolved with lowering the PHT dose. Clobazam and norclobazam levels were not elevated. This interaction is probably related to interference with hepatic degradation of PHT. Clinicians should be aware of possible PHT intoxication in patients starting clobazam.
苯二氮䓬类抗癫痫药物氯巴占可添加到现有的抗癫痫药物治疗中，通常不会产生临床毒性。我们报告了3例患者，在这些患者中，已服用最大耐受剂量苯妥英（PHT）的情况下，加用氯巴占在数周内导致临床上明显的PHT中毒。降低PHT剂量后，症状和高PHT水平得到缓解。氯巴占和去甲氯巴占水平并未升高。这种相互作用可能与干扰PHT的肝脏代谢有关。临床医生应意识到开始使用氯巴占的患者可能会出现PHT中毒。
