Andrewes D G, Bullen J G, Tomlinson L, Elwes R D, Reynolds E H
Epilepsia. 1986 Mar-Apr;27(2):128-34. doi: 10.1111/j.1528-1157.1986.tb03515.x.
This study compares cognitive function in new referrals with epilepsy well-controlled on single drug therapy with either phenytoin or carbamazepine with that in an untreated control group. Patients receiving phenytoin performed consistently less well on memory tasks than did those untreated or receiving carbamazepine. Although patients on phenytoin overall showed a trend towards poorer performance on a tracking task, higher blood levels of this drug were correlated with better tracking performance. The correlation between blood levels of carbamazepine and tracking performance was the opposite from that of phenytoin. Blood levels of carbamazepine were negatively correlated with measures of anxiety, depression, and fatigue. These findings have implications for the choice of drug in the management of epilepsy and also for the reported claims of a psychotropic effect of carbamazepine.
本研究比较了新转诊的、采用苯妥英钠或卡马西平单药治疗且癫痫得到良好控制的患者与未治疗的对照组患者的认知功能。接受苯妥英钠治疗的患者在记忆任务中的表现始终不如未治疗的患者或接受卡马西平治疗的患者。尽管服用苯妥英钠的患者总体上在追踪任务中表现出较差的趋势，但该药物的血药浓度较高与较好的追踪表现相关。卡马西平血药浓度与追踪表现之间的相关性与苯妥英钠相反。卡马西平血药浓度与焦虑、抑郁和疲劳指标呈负相关。这些发现对癫痫治疗中药物的选择以及卡马西平具有精神otropic作用的报道主张具有启示意义。
