Schoeman J F, Elyas A A, Brett E M, Lascelles P T
Dev Med Child Neurol. 1984 Dec;26(6):756-64. doi: 10.1111/j.1469-8749.1984.tb08169.x.
Ninety children with epilepsy were treated with carbamazepine (CBZ) alone or with other anticonvulsant drugs. Side-effects were noted in 14 patients. When 25 patients treated with CBZ alone (group 1) were compared with 27 on CBZ and sodium valproate (group 2) and with 38 on CBZ and one or more other anticonvulsants (group 3), the incidence of side-effects was two in group 1 (of whom one patient had a toxic plasma level of CBZ), but 12 in groups 2 and 3 combined. In all but three of the 14 patients with side-effects, plasma levels of CBZ were within the 'therapeutic range'. A significant difference was found between the carbamazepine-10,11-epoxide (CBZ-10,11-EPOX) levels in plasma and CBZ-10,11-EPOX/CBZ ratio in patients with and without side-effects. For five patients on CBZ and other drugs, changes in treatment resulted in changes in side-effects, and also in CBZ-10,11-EPOX levels. Three of these patients showed an interaction between CBZ and sodium valproate, with a correlation between plasma CBZ-10,11-EPOX and side-effects when either drug was introduced or withdrawn, the plasma levels of CBZ itself and of sodium valproate being within the 'therapeutic range'.
90名癫痫患儿单独使用卡马西平（CBZ）或与其他抗惊厥药物联合治疗。14名患者出现了副作用。将单独使用CBZ治疗的25名患者（第1组）与使用CBZ和丙戊酸钠治疗的27名患者（第2组）以及使用CBZ和一种或多种其他抗惊厥药物治疗的38名患者（第3组）进行比较时，第1组副作用的发生率为2例（其中1例患者CBZ血浆水平达到中毒水平），而第2组和第3组合并起来为12例。在14名出现副作用的患者中，除3名外，其余患者的CBZ血浆水平均在“治疗范围内”。在有副作用和无副作用的患者中，血浆中卡马西平-10,11-环氧化物（CBZ-10,11-EPOX）水平和CBZ-10,11-EPOX/CBZ比值存在显著差异。对于5名使用CBZ和其他药物的患者，治疗的改变导致了副作用的改变，同时也导致了CBZ-10,11-EPOX水平的改变。其中3名患者显示出CBZ与丙戊酸钠之间存在相互作用，当引入或停用任何一种药物时，血浆CBZ-10,11-EPOX与副作用之间存在相关性，CBZ本身和丙戊酸钠血浆水平均在“治疗范围内”。
