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Clinical Trial
. 2004 Jun;109(6):374-7.
doi: 10.1111/j.1600-0404.2004.00291.x.

Improved CNS tolerability following conversion from immediate- to extended-release carbamazepine

A D Miller  1 , G L Krauss, F M Hamzeh
Affiliations
Clinical Trial

Improved CNS tolerability following conversion from immediate- to extended-release carbamazepine

A D Miller et al. Acta Neurol Scand. 2004 Jun.

Abstract

Objectives: Tolerability of 'narrow therapeutic ratio' (NTR) antiepileptic drugs may improve with uniform drug delivery. We determined whether conversion from immediate-release carbamazepine (IR-CBZ) to extended-release carbamazepine (ER-CBZ) decreased the incidence of CNS side-effects associated with drug concentration oscillations.

Methods: We compared CNS side effects and seizure frequency for patients with partial-onset seizures (n = 61) treated with IR-CBZ for > or =1 year with conversion to ER-CBZ for > or =1 year. We compared tolerability findings with absorption variability of the formulations.

Results: Incidence of CNS side-effects decreased from 49% during IR-CBZ treatment to 20% following conversion to ER-CBZ. Patients also had improved tolerability of high doses (> or =1200 mg/day) during ER-CBZ treatment. Pharmacokinetic analysis showed absorption and drug concentration were much more variable for the immediate-release formulation.

Conclusions: This study suggests that ER-CBZ formulations, with smoother drug delivery and less variable absorption, provide improved CNS tolerability compared with immediate-release formulations.

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