Pellock J M
Division of Child Neurology, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298.
Epilepsia. 1987;28 Suppl 3:S64-70. doi: 10.1111/j.1528-1157.1987.tb05780.x.
Most of the side effects associated with carbamazepine (Tegretol, USP, Geigy Pharmaceuticals) therapy are mild, transient, and reversible with an adjustment in dosage or rate of dosage increase. Direct reports to Geigy Pharmaceuticals for the period 1975 to 1986 totaled 371 hematologic, 396 dermatologic, and 156 hepatic and pancreatic occurrences out of more than 4 million patients treated. These include 27 cases of aplastic anemia and 10 of agranulocytosis. In a study of the incidence of side effects in 220 children below the age of 16 years who were receiving carbamazepine, drowsiness, loss of coordination, and vertigo were the most commonly observed side effects and were almost always transient and dose related. The findings of this study are comparable with those of other series assessing carbamazepine-associated adverse reactions in children and adults. Overall, 30 to 50% of children and adults were reportedly free of side effects in these studies. Recommendations for carbamazepine therapy include education of patients and parents in the nature and likelihood of possible serious adverse reactions and routine monitoring to detect laboratory abnormalities.
与卡马西平(痛惊宁,美国药典,嘉基制药公司生产)治疗相关的大多数副作用都很轻微,是短暂的,并且通过调整剂量或增加剂量的速率可逆转。在1975年至1986年期间,向嘉基制药公司直接报告的情况显示,在超过400万名接受治疗的患者中,血液学方面有371例、皮肤方面有396例、肝脏和胰腺方面有156例出现问题。这些包括27例再生障碍性贫血和10例粒细胞缺乏症。在一项对220名16岁以下接受卡马西平治疗的儿童的副作用发生率的研究中,嗜睡、协调能力丧失和眩晕是最常观察到的副作用,而且几乎总是短暂的且与剂量有关。这项研究的结果与其他评估儿童和成人卡马西平相关不良反应的系列研究结果相当。总体而言,据报道在这些研究中30%至50%的儿童和成人没有副作用。卡马西平治疗的建议包括让患者和家长了解可能的严重不良反应的性质和可能性,以及进行常规监测以发现实验室异常情况。