Skip to main content
NCBI home page
British Journal of Clinical Pharmacology logoLink to British Journal of Clinical Pharmacology
. 1992 Jan;33(1):111–114. doi: 10.1111/j.1365-2125.1992.tb04009.x

Rapid tolerance to acute psychomotor impairment with carbamazepine in epileptic patients.

J G Larkin 1, P J McKee 1, M J Brodie 1
PMCID: PMC1381208  PMID: 1540481

Abstract

Thirteen patients with newly diagnosed epilepsy performed a battery of psychomotor function tests before and during the first 12 weeks of carbamazepine (CBZ) therapy. Movement time (P less than 0.025), total choice reaction time (P less than 0.025), finger tapping rate (P less than 0.005) and number cancellation (P less than 0.05) were all significantly impaired after 1 week's treatment, but had returned to baseline by 4 weeks. Mean (+/- s.d.) serum CBZ concentrations and those of its active metabolite CBZ 10,11 epoxide (CBZ-E) were comparable at 1 (CBZ: 8.5 +/- 2.1 mg l-1, CBZ-E: 1.1 +/- 0.68 mg l-1) and 4 weeks (CBZ: 8.1 +/- 4.4 mg l-1, CBZ-E: 0.93 +/- 0.27 mg l-1). These results suggest the rapid development of tolerance to the acute deleterious psychomotor effects of CBZ.

Full text

PDF
111

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andrewes D. G., Bullen J. G., Tomlinson L., Elwes R. D., Reynolds E. H. A comparative study of the cognitive effects of phenytoin and carbamazepine in new referrals with epilepsy. Epilepsia. 1986 Mar-Apr;27(2):128–134. doi: 10.1111/j.1528-1157.1986.tb03515.x. [DOI] [PubMed] [Google Scholar]
  2. Brodie M. J., Feely J. Practical clinical pharmacology. Therapeutic drug monitoring and clinical trials. Br Med J (Clin Res Ed) 1988 Apr 16;296(6629):1110–1114. [PMC free article] [PubMed] [Google Scholar]
  3. Brodie M. J., McPhail E., Macphee G. J., Larkin J. G., Gray J. M. Psychomotor impairment and anticonvulsant therapy in adult epileptic patients. Eur J Clin Pharmacol. 1987;31(6):655–660. doi: 10.1007/BF00541291. [DOI] [PubMed] [Google Scholar]
  4. Gallassi R., Morreale A., Lorusso S., Procaccianti G., Lugaresi E., Baruzzi A. Carbamazepine and phenytoin. Comparison of cognitive effects in epileptic patients during monotherapy and withdrawal. Arch Neurol. 1988 Aug;45(8):892–894. doi: 10.1001/archneur.1988.00520320082020. [DOI] [PubMed] [Google Scholar]
  5. Gillham R. A., Williams N., Wiedmann K. D., Butler E., Larkin J. G., Brodie M. J. Cognitive function in adult epileptic patients established on anticonvulsant monotherapy. Epilepsy Res. 1990 Dec;7(3):219–225. doi: 10.1016/0920-1211(90)90018-q. [DOI] [PubMed] [Google Scholar]
  6. Gillham R. A., Williams N., Wiedmann K., Butler E., Larkin J. G., Brodie M. J. Concentration-effect relationships with carbamazepine and its epoxide on psychomotor and cognitive function in epileptic patients. J Neurol Neurosurg Psychiatry. 1988 Jul;51(7):929–933. doi: 10.1136/jnnp.51.7.929. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. MacPhee G. J., Goldie C., Roulston D., Potter L., Agnew E., Laidlaw J., Brodie M. J. Effect of carbamazepine on psychomotor performance in näive subjects. Eur J Clin Pharmacol. 1986;30(1):37–42. doi: 10.1007/BF00614193. [DOI] [PubMed] [Google Scholar]
  8. Macphee G. J., Brodie M. J. Carbamazepine substitution in severe partial epilepsy: implication of autoinduction of metabolism. Postgrad Med J. 1985 Sep;61(719):779–783. doi: 10.1136/pgmj.61.719.779. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Macphee G. J., Butler E., Brodie M. J. Intradose and circadian variation in circulating carbamazepine and its epoxide in epileptic patients: a consequence of autoinduction of metabolism. Epilepsia. 1987 May-Jun;28(3):286–294. doi: 10.1111/j.1528-1157.1987.tb04220.x. [DOI] [PubMed] [Google Scholar]
  10. Macphee G. J., McPhail E. M., Butler E., Brodie M. J. Controlled evaluation of a supplementary dose of carbamazepine on psychomotor function in epileptic patients. Eur J Clin Pharmacol. 1986;31(2):195–199. doi: 10.1007/BF00606658. [DOI] [PubMed] [Google Scholar]
  11. Macphee G. J., Thompson G. G., Scobie G., Agnew E., Park B. K., Murray T., McColl K. E., Brodie M. J. Effects of cimetidine on carbamazepine auto- and hetero-induction in man. Br J Clin Pharmacol. 1984 Sep;18(3):411–419. doi: 10.1111/j.1365-2125.1984.tb02483.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Meador K. J., Loring D. W., Huh K., Gallagher B. B., King D. W. Comparative cognitive effects of anticonvulsants. Neurology. 1990 Mar;40(3 Pt 1):391–394. doi: 10.1212/wnl.40.3_part_1.391. [DOI] [PubMed] [Google Scholar]
  13. Rapeport W. G., McInnes G. T., Thompson G. G., Forrest G., Park B. K., Brodie M. J. Hepatic enzyme induction and leucocyte delta-aminolaevulinic acid synthase activity: studies with carbamazepine. Br J Clin Pharmacol. 1983 Aug;16(2):133–137. doi: 10.1111/j.1365-2125.1983.tb04976.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Stores G., Hart J., Piran N. Inattentiveness in schoolchildren with epilepsy. Epilepsia. 1978 Apr;19(2):169–175. doi: 10.1111/j.1528-1157.1978.tb05027.x. [DOI] [PubMed] [Google Scholar]
  15. Tomson T., Nilsson B. Y., Levi R. Impaired visual contrast sensitivity in epileptic patients treated with carbamazepine. Arch Neurol. 1988 Aug;45(8):897–900. doi: 10.1001/archneur.1988.00520320095021. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Clinical Pharmacology are provided here courtesy of British Pharmacological Society

RESOURCES