Abstract
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.
MeSH terms
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Aged
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Anti-Anxiety Agents*
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Anticonvulsants / adverse effects*
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Anticonvulsants / blood
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Anticonvulsants / therapeutic use
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Benzodiazepines*
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Benzodiazepinones / adverse effects*
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Benzodiazepinones / blood
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Benzodiazepinones / therapeutic use
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Carbamazepine / blood
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Carbamazepine / poisoning*
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Carbamazepine / therapeutic use
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Clobazam
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Dose-Response Relationship, Drug
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Drug Administration Schedule
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Drug Interactions
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Drug Therapy, Combination
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Electroencephalography / drug effects
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Epilepsy / blood
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Epilepsy / drug therapy*
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Humans
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Male
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Myoclonus / chemically induced*
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Myoclonus / prevention & control
Substances
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Anti-Anxiety Agents
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Anticonvulsants
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Benzodiazepinones
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Benzodiazepines
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Clobazam
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Carbamazepine