新抗てんかん剤Tegretol （5—carbamyl−5H-dibenzo （b, f） azepine）の使用経験

TREATMENT OF EPILEPSY WITH TEGRETOL 5-carbamy1-5H-dibenzo (b, f) azepine), A NEW ANTIEPILEPTIC AGENT

　われわれはiminostilbene誘導体で5—carbamyl—5H-dibenzo　（b,f）　azepineの化学構造をもつ新しい抗てんかん剤Tegretolを大発作および精神運動発作を主とするてんかん患者33名に試用し，つぎの結果を得た。

　1）大発作にたいしては16例中，完全抑制7例，発作頻度が1／2以下に抑制されたもの4例，軽度の効果を認めたもの3例で．計14例（88％）に多少とも有効であつた。無効例は2例のみであつた。

　2）精神運動発作では9例中7例に有効（77％）で，発作が完全に抑制されたもの2例，発作頻度が1／2以下に抑制されたもの2例，軽度の効果を認めたもの3例，無効2例であつた。

　3）2例の自律神経発作および1例の失神発作は完全に抑制されたが，4例の小発作，1例の焦点運動発作，1例のミオクローヌスてんかんにはすべて無効であつた。

　4）本剤の単独使用群において，他種の抗てんかん剤との併用使用群よりすぐれた効果がみられたが，これは後者群には難治例が多いためと考えられる。

　5）てんかん性精神障害は24例中9例で改善をみた。抑うつ気分，被害念慮には著効があつたが，感情不安定，自己固守性，心的活動性低下などの比較的固定しているてんかん性格障害にたいしては軽度の改善をみたにすぎなかつた。

A new anticonvulsant, an iminostilbene derivative with the formula:5-carbamyl-5H-dibenzo (b, f) azepine (Tegretol), has been tried on 33 epileptic patients with seizure of various types, mainly grand mal type and psychomotor type.

The results obtained were as follows:

1) Tegretol was effective in 14 out of 16 grand mal cases (approximately 88%); 7 of these showed complete disappearance of seizures during the medi-cation. In 4 cases the seizure was reduced to less than a half, and in 3 cases the effect less was remark-able.

2) Tegretol was effective in 7 out of 9 cases (77 %) of psychomotor seizure. Of these, 2 cases were controlled completely, and 2 showed reduction of attacks to less than a half. It was slightly effective in 3 other cases, and ineffective in 2 cases.

3) It was completely effective in 2 cases of auto-nomic seizure and 1 case of syncope, but was inef-fective in 4 cases of petit mal, 1 case of localized epilepsy and 1 case of myoclonic epilepsy.

4) The effect of the drug was more prominent in the patients receiving it alone than in those to whom it was given in combination with other ahticonvul-sauts. But the difference is thought to be due to the inclusion of more perverse cases in the latter group.

5) Alleviation of the epileptic psychical disturb-ances was shown in 9 out of 24 cases. It was greatly effective in treating depressed mood and delusion of persecution, but gave only slight improvement to rigid character disturbances, instability of emotion, egotism and psychomotor retardation of epileptic patients.

6) Slight improvement was seen in 2 cases of electro-encephalographical abnormalities, no change in 4 cases and change for the worse in one case.

There was no correlation between the clinical ef-fects and improvement in the EEG.

7) In 14 out of the 33 cases there were observed such side effects as ataxia, drowsiness, digestive dis-turbances, fatigueability, itch, disturbance of spe-ech, nystagmus, and the medication was discotinued in 5 of them. In 6 cases diminution of leucocytes was seen, and the medication was discontinued in three of them.

8) It is to be concluded that this drug is greatly effective for patients of such seizure types as grand mal and psychomotor seizure with an average daily dosage of 0.6g, and may bring about some degree of improvement in patients with epileptic psychical disturbances.