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August 1987

Carbamazepine Plasma Concentration: Relationship to Cognitive Impairment

Author Affiliations

From the Department of Pediatrics, Sections of Neurology (Drs O'Dougherty and Wright) and Clinical Pharmacology and Toxicology (Ms Cox and Dr Walson), The Ohio State University, Columbus.

Arch Neurol. 1987;44(8):863-867. doi:10.1001/archneur.1987.00520200065021

• Neuropsychological function was assessed before and after carbamazepine monotherapy in children with newly diagnosed complex partial epilepsy. Simultaneous video-electroencephalographic monitoring examined the influence of subclinical abnormal electrical discharges on performance. Total and unbound plasma carbamazepine concentrations were examined in relation to changes in performance at low (carbamazepine level, ≤32 μmol/L [≤7.5 mg/L]) and moderate (carbamazepine level, >34 μmol/L [>8.0 mg/L]) drug levels. The data suggest a mild beneficial effect of carbamazepine on speeded eye-hand coordination and, at low drug levels, more rapid processing of items in memory. Efficiency of learning new information and memory-scanning rate displayed a concentration-dependent relationship with carbamazepine level, with poor performance significantly associated with higher carbamazepine plasma concentrations. Carbamazepine free levels were equivalent to total levels in predicting cognitive side effects.

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