A Study of Carbamazepine Utilization in the Hospitals in Yogyakarta Special Province

Abstract

Therapy to control seizures primarily utilizes drugs to date, including carbamazepine. However, carbamazepine has a narrow therapeutic index and is auto-inductive and potential to induce serious adverse reactions, such as Stevens-Johnson Syndrome. This has placed carbamazepine among the priority drugs for which the utilization should be evaluated to ensure safety and effectiveness. This study analyzed the indication, dose, clinical response, and adverse drug reaction (ADR) of carbamazepine by five hospitals in Yogyakarta. The research employed a retrospective cross-sectional design for patients with epilepsy who received carbamazepine for a minimum of 3 days. Patients’ demographics, diagnosis, carbamazepine dose and clinical response, ADR, and concomitant drugs interacting with carbamazepine were collected from medical records during one year of the study. The study involved 78 patients with a majority of male with age of 44.3±13.3 years. The highest indication of carbamazepine was for secondary-type epilepsy (17.95%) with an average maintenance dose of 423.94±135.65 mg/day. Carbamazepine discrepancy was found in absence-type epileptic with an average dose higher than that for other seizure types. Meanwhile, more than 80% seizures could be controlled by carbamazepine monotherapy or its combination. This study found that 16.67% of patients suffered from ADR, particularly a nervous system disorder, with no serious ADR reported. An effective approach is required to improve the appropriateness of antiepileptic drug selection based on the seizure types. In addition, the average maintenance dose of CBZ found in this study, which is relatively lower than those found in studies involving different populations, needs further pharmacogenetic studies of carbamazepine.