SIDE-EFFECTS FROM INCREASED DOSES OF CARBAMAZEPINE ON NEUROPSYCHOLOGICAL AND POSTUROGRAPHIC PARAMETERS OF HUMANS

Patients taking anticonvulsant drugs display a broad spectrum of side- effects. Particularly, in the beginning of treatment and with increasi ng doses of carbamazepine, side effects such as dizziness, ataxia, dro wsiness and reduction of alertness occur, which improve some days afte r the dose has reached a stable level. Our aim was to find objective p arameters for grading these side effects and to differentiate between neurophysiological and neuropsychological side effects of carbamazepin e in a clinical situation. Twenty-two patients with trigeminal neuralg ia were included for a follow-up study with increasing carbamazepine d oses (0 mg to 600 mg). The effect of carbamazepine on postural stabili ty was quantified by posturography. Different neuropsychological tests to study cognitive effects of carbamazepine were performed. The compo site equilibrium score showed a significant reduction of postural stab ility with increasing doses of carbamazepine. In sensory analysis the somatosensory ratio was significantly influenced by increased doses of carbamazepine during the study. Mean reaction time of tonic alertness and phasical alertness varied significantly with different doses of c arbamazepine. There was a significant influence in patients attention during trail making tests and divided attention tests with increase in carbamazepine. In conclusion our observations show that the rate of c hange of carbamazepine doses is an important determinant of cognitive and motor functions in the phase of increasing doses. (C) 1997 Elsevie r Science B.V.