Effectiveness and Tolerability of Carbamazepine vs. Oxcarbazepine as Mood Stabilizers

Abstract

Background.?Patients with bipolar illness or maniac-type schizoaffective disorder often present a variety of symptoms and mixed responses to treatment. Several anticonvulsants have been found effective in the treatment of mood disorders. In the early 70's, the clinical efficacy of carbamazepine in the treatment of acute mania was reported. Oxcarbazepine has been available in the United States since 2000. Both drugs display a different spectrum of properties and side effect profiles. Objective.?To compare the effectiveness and tolerability of carbamazepine and oxcarbazepine in a naturalistic setting. Methods.?A retrospective and concurrent chart review of all patients treated with carbamazepine or oxcarbazepine (n = 33) as mood stabilizers between 01 and 12 2002. The effectiveness was evaluated using the Positive And Negative Syndrome Scale (PANSS). Tolerability was assessed according to side effects recorded on charts. Patients with charts that were not complete were excluded from this study. Results.?There were no significant differences in efficacy between groups on positive (F = 3.575, P = 0.075), negative (F = 2.641, P = 0.121), or the general subscales (F = 1.111, P = 0.306) of the PANSS. Patients in both groups developed gastrointestinal upset and headache, but no significant differences in tolerability between the two therapies were found (χ² = 0.466, df = 1, P = 0.659) and (χ² = 0.195, df = 1, P = 0.367 respectively). Conclusion.?In summary, the patient charts reviewed demonstrated that carbamazepine, as well as, oxcarbazepine are equally effective and tolerable as mood stabilizers.     

3～6岁儿童角色采择与分享行为的关系

目的:研究3~6岁幼儿角色采择能力的发展与分享行为的关系。方法:随机选取临汾市和烟台市的两家幼儿园3~6岁的幼儿,每个年龄段30人,共120名幼儿,通过情景故事法和实验法来测量幼儿的角色采择能力与分享行为的关系。结果:(1)3~6岁的儿童角色采择能力的发展总体上存在显著的年龄差异(m=1.9-3.4),随年龄的增长呈上升趋势,5岁是幼儿角色采择能力发展的关键期;(2)儿童分享行为随年龄增长呈上升趋势(m=0.1-1.9);(3)3~6岁儿童的角色采择能力与分享行为有显著相关,5岁左右的幼儿的相关更显著(t=7.887,8.141,P0.001)。结论:3~6岁幼儿的角色采择能力与分享行为呈显著正相关,5岁左右幼儿的相关更显著。     

HPLC determination of olanzapine and carbamazepine in their nicotinamide cocrystals and investigation of the dissolution profiles of cocrystal tablet formulations

Abstract

Cocrystals have recently gained importance in the pharmaceutical industry. In this study, olanzapine and carbamazepine cocrystals were synthesized by using nicotinamide as cocrystal forming agent to achieve improvements in the physicochemical characteristics of the active ingredients. An HPLC method was developed to determine the amount, thus, the stoichiometric ratios of olanzapine and carbamazepine in the synthesized cocrystals. Olanzapine:nicotinamide and olanzapine tablet formulations were prepared and the developed HPLC method was applied successfully in order to compare the dissolution profiles of these formulations. An ACE 5 CN, 25?cm?×?4.6?mm, 5?µm column was used and a gradient elution program was performed for simultaneous determination of olanzapine, carbamazepine and nicotinamide. Phosphate buffer (pH 5.0, 25?mM) and methanol was used in a ratio from 80:20 to 70:30 while the flow rate was 1?mL?min^?1 for the elution of the compounds within 12?min. In conclusion, two different aims were achieved, the first one was to indicate the stoichiometric ratios of the active ingredients olanzapine and carbamazepine with nicotinamide in their cocrystals, and the second one was the comparison of the dissolution profiles of the olanzapine and olanzapine:nicotinamide cocrystal formulations. It was found that the cocrystal formulation with nicotinamide improved the dissolution profile of olanzapine.     

加巴喷丁与卡马西平治疗复发性三叉神经痛的临床效果分析

目的分析加巴喷丁与卡马西平治疗复发性三叉神经痛的临床效果。方法将2016年1月~2017年8月于本院进行治疗的60例复发性三叉神经痛患者作为研究对象,回顾性分析该60例患者的病历资料,按照治疗方式的不同将患者分成两组,普通组使用卡马西平进行治疗,实验组采用加巴喷丁进行治疗,对比分析两组患者的治疗效果。结果治疗后,实验组患者的VAS评分为(2.5±0.5)分,LSI-B指数为(16.5±2.1),各项指标均优于普通组(P0.05);实验组患者的治疗有效率为93.33%,不良反应发生率为3.33%,两项数据均优于普通组(P0.05)。结论加巴喷丁治疗复发性三叉神经痛的效果明显优于卡马西平,该药可有效缓解患者疼痛,且药物不良反应更少,用药安全可靠,能够显著提升患者的生活质量,应在复发性三叉神经痛的治疗中优先选用。     

Evaluation of Which Reactive Metabolite,If Any,Is Responsible for a Specific Idiosyncratic Reaction

Reactive metabolites are believed to be responsible for most idiosyncratic drug reactions. It is often assumed that if a reactive metabolite is found, it must be responsible for the idiosyncratic reactions associated with that drug. However, the evidence linking reactive metabolites and idiosyncratic reactions is circumstantial at best, and in many cases we have virtually no evidence. Furthermore, it is common for a drug to form several reactive metabolites, so it can be difficult to determine which, if any, is responsible for a given idiosyncratic reaction. Although the reactive metabolite hypothesis is logical, it has important implications for drug development, and we need to develop ways to test the hypothesis for specific drugs rigorously. Valid animal models are a powerful tool for testing whether a specific reactive metabolite is responsible for a specific adverse reaction and for studying further the mechanism by which it may induce such reactions; however, such models are rare.     

抗癫痫药治疗SUNCT综合征的效果观察

目的：验证抗癫痫药治疗SUNCT综合征的有效性。方法采用开放性自身对照研究，对比5例SUNCT综合征对卡马西平和加巴喷丁的治疗反应。结果卡马西平和加巴喷丁两种癫痫药均有效，加巴喷丁优于卡马西平。结论加巴喷丁可作为SUNCT综合征的一线治疗药物。     

癫痫患者服用卡马西平对颈动脉内中膜厚度的影响

目的研究癫痫患者服用卡马西平对颈动脉内中膜厚度(carotid artery intima-media thickness,CA-IMT)的影响。方法选择2012-05—2014-05在我院接受治疗的癫痫患者84例,根据随机数字法分成口服卡马西平组42例(A1组)及癫痫未治疗组(A2组),另选同期在我院接受健康体检的志愿者42例为对照组(B组),对比各组血脂、Hcy及CRP水平,各组CA-IMT水平,分析影响CA-IMT水平的危险因素。结果 A1组TC、TG、LDL-C、Hcy及CRP水平均分别显著高于A2组及B组,差异均有统计学意义(均P0.05)。A1组右侧CA-IMT、左侧CA-IMT及平均CA-IMT水平均分别显著高于A2组及B组,差异均有统计学意义(均P0.05)。Logistic回归分析显示,用药时间及用药总剂量均为影响CA-IMT水平的危险因素。结论癫痫患者经卡马西平治疗对血脂水平具有一定的影响,同时还可增加CA-IMT水平,值得临床应用时关注。