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Microdialysis of Excitatory Amino Acids During EEG Recordings in Freely Moving Rats

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Published on: November 8, 2018

Carbamazepine-induced hyperammonemia.

Erin N Adams¹, Alla Marks, Mitsi H Lizer

¹Bernard J. Dunn School of Pharmacy, Shenandoah University, 1775 North Sector Court, Winchester, VA 22601, USA. eadams@su.edu

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists

|August 12, 2009

Summary

This summary is machine-generated.

Carbamazepine, a medication for bipolar disorder, can cause hyperammonemia, a condition of high ammonia levels in the blood. This case highlights the importance of monitoring ammonia levels during carbamazepine treatment.

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Area of Science:

Neuroscience
Clinical Pharmacology
Toxicology

Background:

Carbamazepine is a widely used antiepileptic and mood-stabilizing drug.
Hyperammonemia is a potentially serious condition characterized by elevated ammonia levels in the blood.
Patients with bipolar disorder often require long-term medication management.

Observation:

A 26-year-old male with bipolar disorder and seizure disorder developed severe agitation and aggressive behavior.
The patient had recently started carbamazepine therapy for aggression and seizure control.
Elevated serum ammonia levels (127 microg/dL) were detected, with therapeutic carbamazepine levels (3.9 microg/mL).

Findings:

Carbamazepine discontinuation led to the normalization of serum ammonia levels within four days.
The patient had a history of elevated ammonia levels with valproic acid and a previous episode with carbamazepine.
This suggests a potential idiosyncratic reaction to carbamazepine causing hyperammonemia.

Implications:

Clinicians should consider monitoring ammonia levels in patients exhibiting unexplained neurological or behavioral changes during carbamazepine therapy.
This case underscores the importance of a thorough medication history, including previous adverse drug reactions.
Further research may be warranted to elucidate the mechanism of carbamazepine-induced hyperammonemia.