1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-6-23 10.15844/pedneurbriefs-6-3-9 Antiepileptic Drugs Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Carbamazepine-Induced Diarrhea http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 03 1992 01 07 2016 6 3 23 24 Copyright: © 1992 The Author(s) 1992 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Intractable diarrhea from carbamazepine

Intractable diarrhea induced by carbamazepine (CBZ) in 3 patients and necessitating discontinuation of the drug is reported from the Departments of Neurology and Medicine, University of Louisville School of Medicine, Kentucky.

 Carbamazepine Diarrhea Carbamazepine-Induced Eosinophilic Colitis

Intractable diarrhea induced by carbamazepine (CBZ) in 3 patients and necessitating discontinuation of the drug is reported from the Departments of Neurology and Medicine, University of Louisville School of Medicine, Kentucky. A 3 year old boy with generalized tonic-clonic seizures received CBZ 125 mg/day, increasing to 125 mg 3 times daily. The CBZ serum level was 7.4 mcg/ml. Frequent diarrhea was associated with negative stool examination and cultures. Liver function studies showed minimal LDH elevation. The gradual withdrawal of CBZ and substitution of phenytoin were followed promptly by recovery. The 2 other patients were adults, both of whom recovered after CBZ was withdrawn and phenytoin or primidone was substituted. [1]

COMMENT. The authors note that diarrhea is described as a complication of CBZ in the package insert but gastrointestinal adverse effects of CBZ have received little attention in the literature. Other GI complications include anorexia, nausea, vomiting and constipation. Hepatic toxicity has been reported in 5%-10% of patients.

Carbamazepine-induced eosinophilic colitis with severe watery diarrhea is reported in an adult from Helsinki, Finland [2]. With 2 reports of CBZ-induced diarrhea appearing in the same issue of Epilepsia, the gastrointestinal side effects of CBZ need to be taken seriously and treated by prompt discontinuation of CBZ.

 Iyer V Holmes JW Richardson RL Intractable diarrhea from carbamazepine Epilepsia 1992 Jan-Feb 33 1 185 187 10.1111/j.1528-1157.1992.tb02304.x 1733755 Anttila VJ Valtonen M Carbamazepine-induced eosinophilic colitis Epilepsia 1992 Jan-Feb 33 1 119 121 10.1111/j.1528-1157.1992.tb02293.x 1733744