RSM logo
JRSM

Home Current issue Browse archive Alerts About the journal Feedback
 
J R Soc Med 1993;86:133-136
© 1993 Royal Society of Medicine

This Article
Right arrow Send a Quick Comment
Right arrow Alert me when this article is cited
Right arrow Alert me when Quick Comments are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Jain, K. K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

Journal of the Royal Society of Medicine, Vol 86, Issue 3 133-136, Copyright © 1993 by Royal Society of Medicine

ORIGINAL ARTICLES

Investigation and management of loss of efficacy of an antiepileptic medication using carbamazepine as an example

KK Jain
Antiepileptic Medications Department of Medicine, Ciba-Geigy Ltd., Basel, Switzerland.

Cases reported as loss of efficacy (secondary failure) of carbamazepine (CBZ) for epilepsy were analysed to determine the cause. In these cases, seizures previously controlled with CBZ, recurred or increased in frequency. The following causes were identified in 131 cases where adequate information was available: use for types of epilepsy where this drug is not recommended, lowering of the blood levels of the drug on switching over from branded to a generic CBZ, change in the galenic form, drug interactions, progression of the underlying brain pathology such as a brain tumor, and unexplained increase in the blood levels of the drug. In cases where the increase in seizures was transient no special measures or changes in therapy were required. Unexplained failure occurred only in seven cases (5.3%). Based on this information, a flow chart was designed to evaluate such a problem step by step and to take appropriate measures. Only when true therapeutic failure is identified, should another antiepileptic drug be substituted for CBZ. Similar approach can be used for other antiepileptic drugs.
Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?




The Cholesterol Controversy

 Developing the Wise Doctor Psychiatry and Crime