ABSTRACT
Carbamazepine (CBZ), a tricyclic iminostilbene derivative, was synthesized by Schindler and Blattner in 1957 and introduced in 1963 in Europe as an antiepileptic drug for the treatment of generalized tonic-clonic seizures and complex partial seizures. CBZ toxicity is usually manifested by disturbance of eye movements with a slowing of saccades and development of gaze-evoked nystagmus resulting in dizziness, blurred vision, and diplopia or a disturbance of balance causing ataxia. Because of the induction of microsomal enzymes by CBZ and the subsequent acceleration of its own metabolism, one can distinguish three different elimination halflives for CBZ depending on the length of treatment. In addition, for patients unable to take CBZ orally, e.g., perioperatively, the drug can be administered rectally in doses similar to those given orally. During pregnancy CBZ biotransformation changes only slightly, which may result in a lower CBZ plasma concentration.
