Lack of carbamazepine toxicity in frail nursing home patients: a controlled study.
OBJECTIVE
To assess the effects of carbamazepine and placebo on measures of toxicity in frail nursing home patients.


METHODS
A nonrandomized, double-blind, placebo-controlled crossover study.


METHODS
Two nursing homes in Rochester, New York.


METHODS
Twenty-five subjects (mean age 84.5 years) with dementia.


METHODS
Carbamazepine and placebo during two 5-week periods separated by a 2-week washout. The modal dose for each patient was 300 mg/day.


METHODS
Adverse experiences, comorbid events, and physical signs and symptoms were assessed continuously, and laboratory data were examined at the beginning and end of each treatment period.


RESULTS
One subject died with a pneumonia (and elevated white blood cell count), and one subject developed probable carbamazepine-induced tics. There was a minimal drop in hematocrit and a slight elevation of liver enzymes, none of which was clinically significant. There was otherwise no excess of adversity or comorbid events on carbamazepine versus placebo, and there was no change in electrolytes or other laboratory measures.


CONCLUSIONS
The findings indicate that carbamazepine in this dose range was well tolerated for the 5-week treatment period in this frail sample. These data supplement the literature regarding carbamazepine toxicity, which is devoid of controlled studies in older subjects.
Tariot
P N
PN
Department of Psychiatry, University of Rochester Medical Center, New York, USA.
Frederiksen
K
K
Erb
R
R
Leibovici
A
A
Podgorski
C A
CA
Asnis
J
J
Cox
C
C
D000368:Aged; D000369:Aged, 80 and over; D002220:Carbamazepine / Q000009:adverse effects*; D015897:Comorbidity; D018592:Cross-Over Studies; D003704:Dementia / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D016330:Frail Elderly; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009735:Nursing Homes; D010865:Pilot Projects
D002220:Carbamazepine