Drake M E, Peruzzi W T
J Natl Med Assoc. 1986 Nov;78(11):1105-7.
A 40-year-old man developed an acute state of manic exultation when given carbamazepine for complex partial seizures. The symptoms subsided when carbamazepine was discontinued, but recurred when the drug was inadvertently given again. This observation does not accord with previous evidence of a beneficial psychotropic effect for carbamazepine in some epileptic patients and of some effect in the treatment of mania. Carbamazepine has been shown to have complex actions on multiple neurotransmitter and neuromodulator systems, and it is possible that paradoxical effects of this nature may occur in susceptible individuals, as has been found with other sedative and anticonvulsant agents. The patient recalled brief euphoric periods after seizures, which may suggest that carbamazepine exacerbated or prolonged preexisting cerebral dysfunction.
一名40岁男性在服用卡马西平治疗复杂部分性癫痫发作时出现了急性躁狂兴奋状态。停用卡马西平后症状消退，但在无意中再次给药时症状复发。这一观察结果与之前关于卡马西平对一些癫痫患者具有有益精神药理作用以及对躁狂症有一定治疗效果的证据不符。已表明卡马西平对多种神经递质和神经调质系统有复杂作用，并且如同其他镇静和抗惊厥药物一样，在易感个体中可能会出现这种矛盾效应。患者回忆起癫痫发作后有短暂的欣快期，这可能提示卡马西平加重或延长了先前存在的脑功能障碍。
