Work

From Felbamate to Carbamazepine: Clinical Consequences of Unintentional Antiepileptic Substitution in Refractory Epilepsy

Year: 2025

Type: article

Abstract: Epilepsy is the most common chronic neurological disorder and one of the leading causes of disability. We report a rare and clinically significant complication involving the inadvertent substitution of felbamate with carbamazepine in a 37-year-old man with refractory epilepsy. He developed drowsiness, ataxia, dysarthria, and vomiting, followed by hematological abnormalities and respiratory symptoms. Although carbamazepine levels were within the reference range, a probable diagnosis of acute carbamazepine toxicity was made in the setting of refractory epilepsy. Therapeutic interventions included discontinuation of carbamazepine, antimicrobial therapy, and supportive care. Inadvertent substitution of antiepileptic medications in patients with refractory epilepsy can lead to serious multisystem complications. Vigilant medication management and multidisciplinary care are essential to prevent adverse outcomes.

Source: Cureus

DOI: 10.7759/cureus.88362

Authors: Natanael Duarte, Omarlyn Ruiz, Elidenia Velásquez

Institution: Universidad Católica Nordestana

Language: English

Topic: Epilepsy research and treatment

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4412495138