The purpose of this study was to determine the occurrence of leukopenia and other blood dyscrasias associated with psychiatric use of carbamazepine and valproate.
Rates of WBC counts of 3,000-4,000/mm3 (moderate leukopenia) and<3,000/MM3 (severe leukopenia), platelet counts of<100,000/MM3, and hematocrit<30% were identified among 2,22 8 treated patients at risk among 11,720 patients admitted to McLean Hospital over 4 years (1989-1993).
Patients who received carbamazepine or valproate and had a blood dyscrasia not associated with a relevant medical condition were compared to patients treated with imipramine or desipramine.
Of 977 patients treated with carbamazepine, 2.1% experienced leukopenia (16 moderate cases, five severe).
Time to 50% risk was 16 days, and recovery occurred within about 6 days after carbamazepine was stopped.
For 1,251 patients given valproate, the occurrence of leukopenia was 0.4% (three moderate cases, two severe).
The occurrence of leukopenia in 1,031 patients given the tricyclic antidepressants was 0.3% (two moderate cases, one severe).
The observed occurrence of moderate leukopenia with carbamazepine was 6.9 and 7.3 times higher than that with valproate and antidepressants, respectively.
Conclusions ; Severe blood dyscrasias were uncommon in psychiatric patients given carbamazepine and were about as rare with valproate as with imipramine or desipramine.
Mots-clés Pascal : Carbamazépine, Valproïque acide, Anticonvulsivant, Toxicité, Composé tricyclique, Hémopathie, Epidémiologie, Facteur risque, Trouble humeur, Homme
Mots-clés Pascal anglais : Anticonvulsant, Toxicity, Tricyclic compound, Hemopathy, Epidemiology, Risk factor, Mood disorder, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0211130
Code Inist : 002B02U02. Création : 09/06/1995.