Abstract
sant drugs may produce a similar state of confusion, with hallucinations, disorientation, anxiety, agitation, insomnia, and exacerbation of psychosis in a few susceptible individuals. 8 Many studies have suggested that carbamazepine has beneficial psychotr0Pic actions, so it is not surprising that it may also produce occasional adverse emotional reactions. Until it is more clear which factors may predispose children to behavioral toxicity, it may be prudent to initiate therapy cautiously and at a low dose in certain patients, especially those with preexisting psychopathologic problems or retardation. Five of our seven patients were eventually able to tolerate the drug when it was reintroduced slowly. This experience suggests that if carbamazepine is needed for seizure control, a previous adverse behavioral reaction is not an absolute contraindication to another careful trial. R E F E R E N C E S 1. Huf R, and Schain R: Long-term experiences with carbamazepine (Tegretol) in children with seizures, J PEDIATR 97:310, 1980. 2. Wallace S: Carbamazepine in childhood seizures, Dev Med Child Neurol 20:223, 1978. 3. Johnston MV, and Freeman JM: Pharmacologic advances in seizure control Pediatr Clin North Am 28:179, 1981. 4. Dodrill CB, and Troupin AS: Psychotropic effects of carbamazepine in epilepsy: A double blind comparison with phenytoin, Neurology 27:1023, 1977. 5. Sillanpaa M: Carbamazepine: Pharmacology and clinical uses, Acta Neurol Scand [Suppl] 88:97, 1981. 6. Livingston S, Pauli LL, and Berman W: Carbamazepine (Tegretol) in epilepsy, Dis Nerv Syst 35:103, 1974. 7. Stores A: Behavioral effects of antiepileptic drugs, Dev Med Child Neurol 17:647, 1975. 8. Goodman A, and Gilman L: The pharmacologic basis of therapeutics, New York, 1980, Macmillan, Inc.
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