Lamotrigine-induced carbamazepine toxicity: an interaction with carbamazepine-10,11 -epoxide

✍ Scribed by T. Warner; P.N. Patsalos; M. Prevett; A.A. Elyas; J.S. Duncan

• Book ID: 103932280
• Publisher: Elsevier Science
• Year: 1992
• Tongue: English
• Weight: 381 KB
• Volume: 11
• Category: Article
• ISSN: 0920-1211
• DOI: 10.1016/0920-1211(92)90049-y

✦ Synopsis

We report an interaction between lamotrigine (LTG), a new antiepileptic drug (AED), and carbamazepine (CBZ) and its primary metabolite CBZ-10,11-epoxide (CBZ-E) in 9 consecutive patients (5 male, 4 female, aged 19-31 years). After introduction of LTG (median daily dose 200 mg, range 100-300 mg) the mean serum CBZ-E concentration increased by 45% (P less than 0.01) and the CBZ-E/CBZ ratio increased by 19% (P less than 0.02). In 4 patients these changes were associated with clinical toxicity (dizziness, nausea, diplopia). The possibility of an increase in serum CBZ-E concentrations needs to be considered if toxicity symptoms develop when LTG is added to CBZ therapy.