Carbamazepine (CBZ) controlled release compared with conventional CBZ: a controlled study of attention and vigilance in children with epilepsy.
To compare the effects on attention and vigilance of conventional carbamazepine (CBZ) and CBZ controlled release (CBZ-CR), 15 schoolchildren with epilepsy and normal intelligence receiving CBZ were switched to CBZ-CR. Psychological examination was performed on the day before (day A) and 1 month after substitution (day B). Measurements of attention and vigilance were repeated throughout the day at 2-h intervals. Both on days A and B, CBZ plasma levels were monitored during a 12-h period. Fifteen matched healthy controls were submitted to identical test programs, allowing comparisons within subjects as well as between patients and control children. Variability of performance over sessions was neither increased nor decreased with CBZ-CR. Consistent differences over sessions did not exist between patients and controls with either drug. No relation was noted between reaction time and CBZ plasma level. The pharmacologic data confirm results of earlier studies in children. We noted a reduction in intradose fluctuations of CBZ level with CBZ-CR as compared with conventional CBZ. The neuropsychological results do not show a difference between the drugs. Neither were differences noted with respect to antiepileptic efficacy and side effects. At the end of the study, all but one of the children (and their parents) opted to receive CBZ-CR for ease of dosage administration and overall satisfaction.