Saxon A J, Whittaker S, Hawker C S
Veterans Administration Medical Center, Seattle, WA 98108.
J Clin Psychiatry. 1989 Jun;50(6):228-9.
Two patients who were concomitantly undergoing methadone maintenance treatment and receiving phenytoin suffered continuing opioid withdrawal symptoms as a results of phenytoin's acceleration of methadone metabolism. When anticonvulsant therapy was discontinued, these patients had seizures. One patient was switched to carbamazepine as an alternative anticonvulsant, but this treatment resulted in a similar clinical problem. When both patients received valproic acid instead, the withdrawal symptoms disappeared and their conditions stabilized.
两名正在接受美沙酮维持治疗并服用苯妥英钠的患者，由于苯妥英钠加速了美沙酮的代谢，出现了持续的阿片类药物戒断症状。当抗惊厥治疗停止时，这些患者发生了癫痫发作。一名患者改用卡马西平作为替代抗惊厥药物，但这种治疗导致了类似的临床问题。当两名患者改用丙戊酸时，戒断症状消失，病情稳定。
