Carbamazepine intoxication with negative myoclonus after the addition of clobazam.
We report a case a carbamazepine (CBZ) intoxication with negative myoclonus that occurred 4 weeks after clobazam (CLB) had been added to a stable regimen of CBZ and topiramate (TPM). Both CBZ and CBZ-epoxide (CBZ-E) blood levels were elevated, and the symptoms resolved quickly when CBZ dosage was reduced and CLB discontinued. CLB was reintroduced a year later with the patient's consent, and the time course of the interaction was studied: CBZ and CBZ-E levels increased slowly over 12 days. The interaction is thus probably related to the progressive increase in Nor-CLB.
Centre Saint Paul, Marseille, France.
P
P
Genton
V H
VH
Nguyen
E
E
Mesdjian
D000368:Aged; D014151:Anti-Anxiety Agents; D000927:Anticonvulsants / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use; D001569:Benzodiazepines; D001570:Benzodiazepinones / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use; D002220:Carbamazepine / Q000097:blood / Q000506:poisoning* / Q000627:therapeutic use; D000078306:Clobazam; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D004569:Electroencephalography / Q000187:drug effects; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D008297:Male; D009207:Myoclonus / Q000139:chemically induced* / Q000517:prevention & control
D014151:Anti-Anxiety Agents; D000927:Anticonvulsants; D001570:Benzodiazepinones; D001569:Benzodiazepines; D000078306:Clobazam; D002220:Carbamazepine