Keränen T, Sivenius J
Acta Neurol Scand Suppl. 1983;97:69-80. doi: 10.1111/j.1600-0404.1983.tb01536.x.
Side effects of carbamazepine (CBZ), valproate (VPA) and clonazepam (CZP) are rare during long-term use but rather common and usually transient during the early phases of treatment. The usual side effects of CBZ are drowsiness, dizziness, and diplopia, which are dose dependent in long-term use, but CBZ does not seem to cause cognitive disturbances, as do phenobarbital and phenytoin. Other reactions to CBZ may include leukopenia, hyponatremia, disturbances of vitamin D metabolism and fortunately rarely, agranulocytosis and hepatitis. Use of VPA can lead to gastrointestinal discomfort, weight gain, hair loss, tremor and sedation, but these side effects are rather uncommon, mild, and transient during VPA monotherapy. Potentially hazardous reactions such as hepatitis and pancreatitis have occurred in a few patients on VPA, generally with multidrug therapy. Some of the side effects are dose related. They infrequently lead to withdrawal of VPA. Side effects limited to initiation of CZP therapy include drowsiness, ataxia, and behavioral changes; they are usually transient but can lead to dose reduction or even withdrawal of the drug. Except for development of tolerance, CZP seems to be practically free of long-term side effects.
卡马西平（CBZ）、丙戊酸盐（VPA）和氯硝西泮（CZP）的副作用在长期使用时较为罕见，但在治疗初期却相当常见且通常是短暂的。CBZ常见的副作用有嗜睡、头晕和复视，长期使用时这些副作用与剂量相关，但与苯巴比妥和苯妥英不同，CBZ似乎不会引起认知障碍。对CBZ的其他反应可能包括白细胞减少、低钠血症、维生素D代谢紊乱，幸运的是粒细胞缺乏症和肝炎很少见。使用VPA可导致胃肠道不适、体重增加、脱发、震颤和镇静，但在VPA单药治疗期间，这些副作用相当罕见、轻微且短暂。在接受VPA治疗的少数患者中，通常是在多药联合治疗时，出现过如肝炎和胰腺炎等潜在危险反应。有些副作用与剂量有关。这些副作用很少导致停用VPA。仅限于CZP治疗开始阶段的副作用包括嗜睡、共济失调和行为改变；它们通常是短暂的，但可能导致剂量减少甚至停药。除了产生耐受性外，CZP似乎几乎没有长期副作用。
