Carbamazepine-induced hepatitis in a patient with cervical myelopathy

Lamotrigine in the treatment of chronic refractory neuropathic pain

Many patients suffer from chronic, intractable neuropathic pain. Despite similar diagnoses and presumed pathophysiologies, symptoms and response to treatment can differ. Monotherapy is only occasionally successful. In this prospective survey, 20 patients with chronic, neuropathic pain not responding to interventional therapy received lamotrigine, sometimes as monotherapy and sometimes combined with oral morphine. The latter occurred in patients who lost pain relief from morphine after time. Ten patients did not respond to the drug; 4 were temporary responders and 6 patients obtained sustained pain relief. It is interesting that 5 patients regained opioid responsiveness and that the drug combination produced excellent pain relief for more than 5 months. We hypothesize an additive effect between morphine and lamotrigine.

Carbamazepine-induced hepatorenal failure in a child

Carbamazepine is used to manage generalized tonic-clonic, partial, and mixed partial and generalized seizure disorders in children. It is frequently associated with neurologic adverse events, Stevens-Johnson syndrome, and hematologic side effects. Hepatic and renal adverse effects are less common but can cause death. A 6-year-old boy receiving carbamazepine for partial seizure disorder developed hepatorenal failure. With discontinuation of the drug, his liver and kidney function returned to normal within 2 weeks.