Preliminarily Analysis of Carbamazepine (CBZ) C0 in Patients Visited Isfahan Epileptic Clinics

Abstract

Background: Carbamazepine (CBZ) is mostly considered as the first line of effective treatment against simple or complex partial seizure and primary‑secondary generalization. To prevent side‑effects related to higher amount of CBZ minimum concentration (C0) in body fluid or seizure attacks associated to lower amount of CBZ‑C0, the suggested minimum therapeutic concentrations range from 4 to 12 ng/ml (according to previous publications). The aim of this preliminarily study was to investigate the scope of discrepancy associated to the C0 of CBZ in patients visited Isfahan Epileptic Clinic.

Methods: A cross‑sectional study of 22 patients located in neurology ward of Isfahan Neurosciences Research Centre (INRC) was carried out between April 1, 2012 and December 31, 2012. Female (n = 9) and male subjects (n = 13) with a mean age of 27.4 years (range; 16‑38 years) were studied. Pharmacological (CBZ‑C0) and demographical variables were recorded and processed in excel.

Results: The results of CBZ‑C0 showed wide inter‑individual variability. The mean value of CBZ‑C0 was 7.2 ng/ml. In 10 out of 22 patients, CBZ‑C0 were lower than the suggested therapeutic window (4‑12 ng/ml). CBZ‑C0 in nine patients was non‑detectable and in one patient was 0.5 ng/ml (45% <4 ng/ml). In 55% of the patients, CBZ‑C0 ranged from 4.8 to 12 ng/ml.

Conclusions: A schedule therapeutic drug monitoring based on measurement of CBZ‑C0 for individual patient could be a practical marker to achieve therapeutic objectives. Further study related to correlating of CBZC0 to clinical events in Iranian Epileptic population seems to be valuable.

Keywords: C0, carbamazepine, epilepsy, Iranian