correspondence and M.D., Massachusetts General Hospital-McLean Dept. of Psychiatry, Boston, MA, USA.
Psychosomatics. 2010 Nov-Dec;51(6):532-5. doi: 10.1176/appi.psy.51.6.532.
Polytherapy is common in the management of bipolar disorder, as are the side effects associated with this treatment strategy.
The authors review the literature on drug-drug interactions involving oxcarbazepine and identify specific mechanisms that may have clinical importance.
The authors provide a case report of a patient who developed phenytoin toxicity associated with an oxcarbazepine-phenytoin interaction.
Co-administration of phenytoin and oxcarbazepine resulted in toxic levels of phenytoin. Therefore, the patient's daily dosage of oxcarbazepine and phenytoin were reduced.
Although oxcarbazepine is an inducer of the 3A4 isoenzyme, it acts as an inhibitor of the 2C19 isoenzyme, and it can raise levels of other agents, for example, phenytoin, that are also metabolized by this isoenzyme.
在双相情感障碍的治疗中，联合治疗很常见，这种治疗策略也会伴随副作用。
作者综述了涉及奥卡西平的药物-药物相互作用的文献，并确定了可能具有临床重要意义的特定机制。
作者提供了一例患者的病例报告，该患者发生了与奥卡西平-苯妥英相互作用相关的苯妥英中毒。
苯妥英和奥卡西平联合使用导致了苯妥英的中毒水平。因此，减少了患者奥卡西平和苯妥英的日剂量。
尽管奥卡西平是 3A4 同工酶的诱导剂，但它作为 2C19 同工酶的抑制剂，可提高其他同样由该同工酶代谢的药物（如苯妥英）的水平。
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