Summary: In our clinic intermittent side effects–particularly diplopia, drowsiness, and headache–were often seen during the use of carbamazepine. It was remarkable that the complaints were not mentioned spontaneously but had to be asked for very specially in order to track them. They did not correlate with the serum concentrations determined in blood samples taken in the morning. In 43 patients suffering from intermittent side effects and using carbamazepine in combination with one or more anticonvulsants, blood samples were taken and analysed every 2 hr from 8 a.m. to 6 p.m. There appeared to be rather rapid resorption: Each patient showed a more or less prominent increase in the serum level 2 hr after carbamazepine intake. In the course of the afternoon, a maximum was often reached that was attended by side effects. The fluctuations were rather large: The average minimal serum concentration was 5.0 mg/liter, (SD ± 1.4 mg/liter), the average maximal concentration 10.0 mg/liter (SD ± 1.6 mg/liter). Fluctuation from the average was 68.5% (SD ± 21.2%). We also examined 19 patients on monotherapy of carbamazepine. In this group, fluctuations were less: The average minimal concentration was 5.5 mg/liter, (SD ± 1.0 mg/liter), the average maximal concentration 7.8 mg/liter (SD ± 1.6 mg/ liter). Fluctuation from the average was 34.5% (SD ± 10.9%). In both groups the drug was administered three times a day in equal doses at 8 a.m., 12.30 p.m., and 8 p.m. After changing the scheme of intake in such a way that the serum levels did not exceed 8 mg/liter, the side effects disappeared. As a rule, the 12.30 p.m. dose was diminished. None of the patients showed an increase of seizure frequency after this change. RÉSUMÉ Nous avons sou vent observé dans notre clinique, des effets secondaires àĽusage de la carbamazépine, principalement sous la forme de diplopie, de somnolence et de maux de tête, qui surviennent de façon intermittente. Ces effets ne sont ďailleurs pas mentionnés spontanément par les malades et doivent être recherchés. De plus ils ne sont pas en relation avec la concentration sérique déterminee par un prélèvement sanguin du matin. Chez 43 malades présentant de tels effets et utilisant la carbamazépine en combinaison avec un ou plusieurs autres anti‐convulsivants, nous avons effectués les dosages sur des prélèvements effectués toutes les 2 heures de 8 heures à 18 heures. II est apparu une assez grande rapidité de résorption, chaque patient montrant une augmentation plus ou moins importante du taux sérique de carbamazépine deux heures après la prise du médicament. Dans le courant de Ľaprès‐midi on observait souvent un maximum qui correspondait aux effets secondaires. Les fluctuations étaient assez importantes: la concentration moyenne minimum étant de 50 mg/litre (SD ± 1.4 mg/litre) et la concentration moyenne maximum de 10.0 mg/litre (SD ± 1.6 mg/litre). Les fluctuations par rapport à la moyenne étaient de 68.5% (SD ± 21.2%). Nous avons également examiné 19 patients en monothérapie avec la carbamazépine. Dans ce gro...

People suffering from epileptic seizures are often confronted with restrictions resulting from their attacks, such as exclusion from several professions and from some sports, not being allowed to drive a car, and prohibition of alcohol. Consultation of manuals to trace the literature studies on which this last prohibition was based was unsuccessful since there was no mention of the original research from which it appeared that alcohol was provocative of seizures. To be able to give a well-founded judgment on the influence of social alcohol intake on epilepsy, research was undertaken with epileptic patients who had never before or very sporadically used alcohol. During 16 weeks, twice a week, in a clinical setting, 1-3 glasses of an alcoholic beverage were consumed within a period of 2 h. The examination could be carried out double-blind since the drink that was chosen, vodka, is odorless and cannot be tasted when mixed with orangeade. We concluded the following. (a) No influence of social alcohol use on tonic-clonic convulsions or partial complex seizures is demonstrable. (b) Blood levels of carbamazepine, phenobarbital, and phenytoin are not influenced by alcohol intake. The valproic acid concentration is possibly slightly increased. However, this needs further examination before judgment can be made. (c) Both in frequency bands and in the amount of epileptic activity, no change is produced by alcohol use.

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