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Updated: Aug 11, 2026

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Circadian carbamazepine toxicity
W E Haefeli1, P G Meyer, T F Lüscher
1Department of Internal Medicine, University Hospital, Basel, Switzerland.
Abstract:
Owing to marked fluctuations in plasma concentrations, circadian CNS toxicity (maximum in the early afternoon) occurred in a 69-year-old female patient being treated with an instant-release formulation of carbamazepine (CBZ). The neurologic syndrome was reversible after administration of the same daily dose as sustained-release formulation. This case illustrates the importance of correct timing of blood sampling to detect drug-induced toxicity and of use of sustained-release formulations in antiepileptic therapy with CBZ.
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