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  • Title: Lamotrigine-induced carbamazepine toxicity: an interaction with carbamazepine-10,11-epoxide.
    Author: Warner T, Patsalos PN, Prevett M, Elyas AA, Duncan JS.
    Journal: Epilepsy Res; 1992 Apr; 11(2):147-50. PubMed ID: 1618180.
    Abstract:
    We report an interaction between lamotrigine (LTG), a new antiepileptic drug (AED), and carbamazepine (CBZ) and its primary metabolite CBZ-10,11-epoxide (CBZ-E) in 9 consecutive patients (5 male, 4 female, aged 19-31 years). After introduction of LTG (median daily dose 200 mg, range 100-300 mg) the mean serum CBZ-E concentration increased by 45% (P less than 0.01) and the CBZ-E/CBZ ratio increased by 19% (P less than 0.02). In 4 patients these changes were associated with clinical toxicity (dizziness, nausea, diplopia). The possibility of an increase in serum CBZ-E concentrations needs to be considered if toxicity symptoms develop when LTG is added to CBZ therapy.
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