Pn. Tariot et al., LACK OF CARBAMAZEPINE TOXICITY IN FRAIL NURSING-HOME PATIENTS - A CONTROLLED-STUDY, Journal of the American Geriatrics Society, 43(9), 1995, pp. 1026-1029
OBJECTIVE: To assess the effects of carbamazepine and placebo on measu
res of toxicity in frail nursing home patients. DESIGN: A nonrandomize
d, double-blind, placebo-controlled crossover study. SETTING: Two nurs
ing homes in Rochester, New York. PARTICIPANTS: Twenty-five subjects (
mean age 84.5 years) with dementia. INTERVENTION: Carbamazepine and pl
acebo during two 5-week periods separated by a 2-week washout. The mod
al dose for each patient was 300 mg/day. MEASUREMENTS: Adverse experie
nces, comorbid events, and physical signs and symptoms were assessed c
ontinuously, and laboratory data were examined at the beginning and en
d of each treatment period. RESULTS: One subject died with a pneumonia
(and elevated white blood cell count), and one subject developed prob
able carbamazepine-induced ties. There was a minimal drop in hematocri
t and a slight elevation of liver enzymes, none of which was clinicall
y significant. There was otherwise no excess of adversity or comorbid
events on carbamazepine versus placebo, and there was no change in ele
ctrolytes or other laboratory measures. CONCLUSION: The findings indic
ate that carbamazepine in this dose range was well tolerated for the 5
-week treatment period in this frail sample. These data supplement the
literature regarding carbamazepine toxicity, which is devoid of contr
olled studies in older subjects.