Interactions between clobazam and standard antiepileptic drugs in patients with epilepsy.
Interactions between clobazam and standard antiepileptic drugs in patients with epilepsy.
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氯巴扎姆和标准抗癫痫药物在癫痫患者中的相互作用。
DOI：
10.1097/00007691-199208000-00002
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发表时间：
1992
影响因子：
2.5
通讯作者：
J. Roger
中科院分区：
文献类型：
--
作者：
S. Sennoune;E. Mesdjian;J. Bonneton;P. Genton;C. Dravet;J. Roger
我们回顾收集了96名成年癫痫患者在稳定单一治疗下的血药浓度评估，包括氯巴坦(CLB)9例，卡马西平(CBZ)34例，苯巴比妥(PB)24例，苯妥英钠(PHT)9例，丙戊酸盐(VPA)20例；这些结果与CLB联合CBZ(n=17)、PB(n=17)、PHT(n=5)或VPA(n=15)联合治疗的54名成人患者的结果进行了比较。我们的结果表明，CLB对CBZ、PB、PHT或VPA的水平剂量比(LDR)没有显著影响。反之，CBZ、PB和PHT可显著降低CLB的LDR。CBZ和PHT显著增加CLB的主要代谢物N-去甲基氯巴坦(NCLB)的LDR。在CBZ+CLB、PB+CLB和PHT+CLB生物疗法中，NCLB/CLB比值显著升高。这些发现具有临床意义：氯巴赞可用于人类癫痫的辅助治疗，并经常被选为慢性难治性癫痫的苯二氮卓类辅助药物。可能会出现镇静副作用，特别是在接受CBZ+CLB或PHT+CLB生物疗法治疗的患者中，应监测此类患者的CLB和NCLB血浆水平。
We retrospectively collected plasma level assessments performed in 96 adult patients with epilepsy on stable monotherapy, including 9 patients on clobazam (CLB), 34 on carbamazepine (CBZ), 24 on phenobarbital (PB), 9 on phenytoin (PHT), and 20 on valproate (VPA); these results were compared to those obtained in 54 adult patients on stable bitherapy with the association of CLB with either CBZ (n = 17), PB (n = 17), PHT (n = 5), or VPA (n = 15). Our results show that CLB has no significant effect on the level to dose ratio (LDR) of CBZ, PB, PHT, or VPA. Conversely, CBZ, PB, and PHT significantly decrease the LDR of CLB. CBZ and PHT significantly increase the LDR of N-desmethylclobazam (NCLB), the major metabolite of CLB. A significant increase in the NCLB/CLB ratio was found in CBZ + CLB, PB + CLB, and PHT + CLB bitherapies. These findings are of clinical significance: clobazam is useful as adjunctive treatment in human epilepsy and is often chosen as the benzodiazepine adjunctive drug in chronic resistant epilepsy. Sedative side effects may occur, especially in patients treated by a CBZ + CLB or PHT + CLB bitherapy, and both CLB and NCLB plasma levels should be monitored in such patients.