Lesser R P, Pippenger C E, Lüders H, Dinner D S
Neurology. 1984 Jun;34(6):707-11. doi: 10.1212/wnl.34.6.707.
We evaluated the therapeutic efficacy and toxicity of high-dose monotherapy, using carbamazepine or phenytoin, in patients with previously uncontrolled seizures. Treatment with a single drug was equal to or better than polypharmacy, but only a few patients became free of seizures. Toxicity was mild and associated with higher total plasma levels after polypharmacy. Free fractions ranged from 0.14 to 0.30 for carbamazepine and from 0.60 to 0.13 for phenytoin. Toxicity was associated with free phenytoin levels above 3 micrograms/ml; there was no clear relationship between free carbamazepine level and toxicity.
我们评估了使用卡马西平或苯妥英进行高剂量单一疗法对既往癫痫发作未得到控制的患者的治疗效果和毒性。单药治疗与联合用药的效果相当或更好，但只有少数患者癫痫发作停止。毒性较轻，且联合用药后总血浆水平较高。卡马西平的游离分数范围为0.14至0.30，苯妥英的游离分数范围为0.60至0.13。毒性与游离苯妥英水平高于3微克/毫升有关；游离卡马西平水平与毒性之间没有明确的关系。
