Carbamazepine as a substitute treatment of single and compound seizures.

Carbamazepine is a suitable substitute for phenobarbital, primidone, and phenytoin, alone or in combination, when used in the treatment of generalized tonic-clonic or partial epilepsy. Seventy-five percent of 19 patients successfully transferred to carbamazepine and clinically their seizures were at least as well controlled during 18 months of observation. Carbamazepine, alone, is not a satisfactory substitute for drug combinations used in the treatment of compound epilepsy. Fifty percent of 18 patients were successfully transferred to carbamazepine but few of them were significantly improved during the 24 month follow-up. The gradual replacement of standard anticonvulsants with carbamazepine can be accomplished without seizure exacerbation, often with improved control and patient satisfaction. Unfavorable reactions usually are brief, provided serum levels are established between 5 and 12 micrograms/ml.