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To the Editor.
—The recent use of pharmacokinetic parameters and serum anticonvulsant testing has resulted in better management of patients with seizure disorders who require anticonvulsant therapy. The availability of certain anticonvulsants from different pharmaceutical manufacturers has resulted in increased difficulty in optimally treating such individuals. Recently, generic forms of carbamazepine have become available and we wish to report decreased serum carbamazepine levels in one subject using therapy with a generic compound.
Report of a Case.
—A 30-year-old woman with confirmed partial complex seizures, well-controlled on carbamazepine (Tegretol) therapy, with stable morning predose anticonvulsant levels (Nov 12, 1985, 8400 mg/L [35557 μmol/L]; April 5, 1986, 9700 mg/L [41 060 μmol/L]; and May 5, 1986, 7300 mg/L [30 900 μmol/L], at a rate of 400 mg/24 h), was recently started on generic carbamazepine (Goldline) therapy. Following initiation of generic carbamazepine therapy, increased seizure activity was noted. A serum carbamazepine level was
Koch G, Allen JP, Joynt RJ. Untoward Effects of Generic Carbamazepine Therapy. Arch Neurol. 1987;44(6):578–579. doi:10.1001/archneur.1987.00520180004003
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