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Torbjörn Tomson, MD; Leif Bertilsson, PhD

Arch Neurol. 1984;41(6):598-601.

Abstract
• The clinical effects of carbamazepine-10,11-epoxide were assessed in six patients with trigeminal neuralgia. The patients were first given an optimal therapeutic dose of carbamazepine. Part of or the entire carbamazepine dose was then exchanged for the metabolite carbamazepine-10,11-epoxide for three to six days. The patients were unaware of changes in the therapeutic regimen (single-blind). Carbamazepine dosages ranged from 400 to 1,400 mg/day and carbamazepine10,11-epoxide dosages ranged from 300 to 1,000 mg/day. The clinical effects were assessed by the patients' recordings of pain attacks. When carbamazepine-10,11-epoxide and carbamazepine were given in similar doses, the pain control was comparable. On a plasma concentration basis, carbamazepine10,11-epoxide had a considerably higher pain-relieving potency than carbamazepine. During carbamazepine treatment, the epoxide metabolite contributes to the antineuralgic effect to an extent that might be comparable to that of the parent drug. No side effects were seen during carbamazepine-10,11-epoxide therapy.

Author Affiliations
From the Departments of Neurology, Söder Hospital (Dr Tomson) and Clinical Pharmacology, Huddinge Hospital (Dr Bertilsson), Karolinska Institute, Stockholm.

Footnotes
Accepted for publication July 20, 1983.

Reprint requests to Department of Neurology, Söder Hospital, S-100 64 Stockholm, Sweden (Dr Tomson).

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