Carbamazepine monotherapy in epileptic out-patients

The effect and side-effects of carbamazepine monotherapy have been studied retrospectively in 280 epileptic out-patients. The majority of these patients suffered from grand mal epilepsy, partial complex seizures or a combination of both seizure types. Side-effects, in 63% exanthema, led to withdrawal in 10% of the patients. Satisfactory effect of treatment, defined as reduction of seizure frequency by at least 75% or unchanged satisfactory seizure control, was seen in 76% of patients, most commonly those with grand mal. Deterioration was observed in 9% of patients. These results were independent of whether or not carbamazepine monotherapy was drug of first choice. Serum concentrations of carbamazepine, measured in 236 patients, were found to be within the therapeutic range in 72% and above the range in 22%. Our results, which we consider to represent 'normal daily life in an epilepsy out-patient clinic', are comparable with those of controlled prospective studies, but there was a considerably higher frequency of withdrawal due to side-effects.