Tomson T, Ekbom K
Cephalalgia. 1981 Jun;1(2):91-7. doi: 10.1111/j.1468-2982.1981.tb00015.x.
Eight in-patients with idiopathic trigeminal neuralgia (TN) were studied while receiving carbamazepine (CBZ) treatment. The aim was to study diurnal pain distribution, its relation to CBZ dosing and plasma concentration and the effect of decreasing the dose. All pain attacks were registered by the patients at three-hour intervals. CBZ was given b.i.d. in a single blind manner with the patient unaware of dose and dose changes. Plasma concentrations of CBZ were followed every fourth hour during a period of altogether sixteen dosage intervals. The diurnal pain distribution revealed marked intra-individual similarities with pain-free nights and a significant drop in pain during mid-day hours. The latter coincided in time with the peak plasma concentration of CBZ, thus indicating an effect of plasma concentration fluctuations on pain relief. Shorter dosage intervals might therefore be beneficial in problem cases. A significant increase in pain was detected within six to nine hours after a dose reduction, whereas the full effect of the dose change seemed to be established only after one day.
对8例接受卡马西平（CBZ）治疗的特发性三叉神经痛（TN）住院患者进行了研究。目的是研究日间疼痛分布、其与CBZ给药及血浆浓度的关系以及降低剂量的效果。患者每隔3小时记录所有疼痛发作情况。CBZ以单盲方式每日给药2次，患者不知道剂量及剂量变化。在总共16个给药间隔期间，每4小时监测一次CBZ的血浆浓度。日间疼痛分布显示个体内有明显相似性，夜间无痛，中午时段疼痛显著减轻。后者与CBZ血浆浓度峰值在时间上一致，因此表明血浆浓度波动对疼痛缓解有影响。因此，在问题病例中较短的给药间隔可能有益。剂量降低后6至9小时内疼痛显著增加，而剂量变化的全部效果似乎仅在1天后才显现。
