Carbamazepine and Electro Convulsive Threshold

The patient was getting lithium 1800 mg., Carbamazepine (CBZ) 800 mg. and I'henob.irbitone (PB) 60 mg./day. It is difficult, especially in an epileptic subject, to incriminate CBZ alone out of combination of these three drugs which interact with each other in a complex manner and influence seizure activity. Absctuc or scrum levels of PB and CBZ further limits the experimental design and the scope of extrapolation of the data. In addition, animal experiments indicate that CBZ suppresses kindling process by repetitive sub-threshold electrical stimulation of the limbic structures and propagation of kindled seizure discharge to other brain areas (Wada 1977). On the whole, the evidence to date suggests that the site of action of CBZ is predominantly on the limbic structures rather than the midbrain reticular formation or thalamus.