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Time course of carbamazepine autoinduction

Department of Neurology, Division of Clinical Neurophysiology, Children's Hospital, Boston, and Departments of Neurology and Pharmacology, Boeton University School of Medicine and Boston Veteran's Administration Medical Center, Boston, MA; and the VA Cooperative Program Coordinating Center, Perry Point, MD.

We sequentially determined carbamazepine clearance values in 17 patients at the end of weeks 1, 2, 4, 8, and 12 of monotherapy. There were no significant differences among these clearance values. In 11 of 17 patients, week 1 clearance accurately predicted week 12 carbamazepine serum concentration (within ±33%). Our data indicate that carbamazepine auto induction was completed within the first 1 or 2 weeks of monotherapy. Serum concentration values obtained after 1 week of monotherapy, using our dosing regimen, can be used to predict directly the dosing rate needed to obtain a specific serum concentration in most patients.

Address correspondence and reprint requests to Dr. Browne, Veteran's Administration Medical Center, 150 S. Huntington Avenue, Boston, MA 02130.

Supported in part by the Veteran's Administration. During the preparation of this manuscript Dr. Mikati was a Merritt-Putnam fellow supported by the Epilepsy Foundation of America.

Presented in part at the thirty-ninth annual meeting of the American Academy of Neurology, New York, NY, April 1987.

Received April 22, 1988. Accepted for publication in final form October 3, 1988.

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