01 March 2001
Neurotoxic sequele after tramadol in an epileptic patient treated with karbamazepin
Barbara ChmielewskaCase Rep Clin Pract Rev 2001; 2(1):28-32 :: ID: 474527
Abstract
A case of acute toxic encephalopathy in a man treated with carbamazepine for epilepsy after the administration of tramadol in order to alleviate sciatic neuralgia. The generalized cerebral symptoms, as well as cerebellar and extrapyramidal ones and changes in electroencephalography characteristic of carbamazepine poisoning, observed in this case, are not specific and have also been observed after the overdose of other neurodepressive drugs, including tramadol. The disorders caused by co-administration of the drugs in submaximal therapeutic doses were fully reversible after the discontinuation of tramadol. The active metabolites of the drugs, 10, 11-epoxide-CBZ and O-methyltramadol, whose formation is dependent primarily on the individual activity of hepatic enzymes and on the influence of polytherapy, contribute to the neurotoxic effects of carbamazepine and tramadol. Carbamazepine, inducing the turnover of tramadol to its O-methyl derivative, can theoretically reduce its analgesic activity and increase the risk of toxicity. This clinical example of theoretically justified unfavorable interaction of carbamazepine and tramadol is noteworthy, because these two drugs possessing analgesic activity are often co-administered in drug-resistant pain syndromes.
Keywords: Carbamazepine, Tramadol, treatment of neuralgia, neurotoxic side effects
0
In Press
12 Feb 2024 : Case report
Diagnostic Challenges and Imaging Considerations for Intraparotid Facial Nerve Schwannoma: A Case Report an...Am J Case Rep In Press; DOI: 10.12659/AJCR.942870
12 Feb 2024 : Case report
Erdheim-Chester Disease Occult on Radiographs and CT but Visible on MRI and PETAm J Case Rep In Press; DOI: 10.12659/AJCR.941169
12 Feb 2024 : Case report
Surgical Treatment of Spontaneous Superficial Temporal Artery Arteriovenous Malformation: A Case ReportAm J Case Rep In Press; DOI: 10.12659/AJCR.942839
13 Feb 2024 : Case report
Warfarin Woes: A Rare Case of Hemoperitoneum with Intramural Small Bowel HematomaAm J Case Rep In Press; DOI: 10.12659/AJCR.943519
Most Viewed Current Articles
10 Jan 2022 : Case report
A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...DOI :10.12659/AJCR.935263
Am J Case Rep 2022; 23:e935263
19 Jul 2022 : Case report
Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19DOI :10.12659/AJCR.936128
Am J Case Rep 2022; 23:e936128
05 Mar 2022 : Case report
Acute Limb Ischemia After Self-Injection of Crushed Morphine Tablets into the Radial Artery: Role of Infrar...DOI :10.12659/AJCR.935336
Am J Case Rep 2022; 23:e935336
02 Apr 2022 : Case report
Infective Endocarditis Caused by Pseudomonas luteola in a Pediatric Patient. A Case Report and Review of Li...DOI :10.12659/AJCR.935743
Am J Case Rep 2022; 23:e935743