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Carbamazepine—A double-blind comparison with phenytoin

Seizure Clinic, Department of Neurological Surgery, Department of Pharmacology, Division of Electroencephalography and Clinical Neurophysiology of the Department of Laboratory Medicine, and Department of Biostatistics, School of Public Health and Community Medicine, University of Washington, Seattle, Washington.

In a double-blind crossover study, carbamazepine and phenytoin were compared as single anticonvulsants in 47 patients with focal and major generalized seizures. Each drug provided superior seizure control in about half the patients, but significantly fewer patients had objective side effects while taking carbamazepine. Neuropsychologic testing showed improved performance in cognitive function and emotional status of patients while on carbamazepine. No hematotoxic complications arose, but vigilant follow-up is advised. Mean serum level of carbamazepine was 9.3 µg per milliliter with a suggested therapeutic range of 8 to 12 µg per milliliter, reached by eventual doses of 16 to 20 mg per kilogram. Carbamazepine offers an independent choice of improved seizure control with a possibility of fewer side effects.

Dr. Troupin's address is Epilepsy Center, ZA50, University of Washington, Hartorview Hospital, Seattle, Washington 98104.

This study was supported by NIH contract N01-NS-0–2281 and Grant NS04053 awarded by National Institute of Neurological and Communicative Disorders and Stroke, PHS/DHEW.

Received for publication May 13, 1976.

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