DRUGS FOR PARTIAL SEIZURES AND TONIC-CLONIC SEIZURES: SIDE EFFECTS OF CARBAMAZEPINE
The side effect of carbamazepine that worries most parents (and physicians) is a decrease in the white blood cells, responsible for fighting infection. The normal white blood cell count is in the range of 5000-8000 cells. Children (or adults) who are taking carbamazepine often have lower white cell counts, perhaps 3000—5000. In one in ten such children, this lowering of the white count is temporary; it persists in only two percent. Usually this persistent low white cell count is of no consequence since the child is able to fight infections just as well as anyone else.
If your child has a low white count while on carbamazepine, don’t panic. Sometimes your child’s white count may be low from a viral infection. Your physician may want to repeat the count in five to seven days. If it has come back toward normal, the carbamazepine can be continued. If it has dropped further, the drug may need to be stopped temporarily. Stopping the drug suddenly may cause seizures to recur.
Aplastic anemia, in which the bone marrow stops producing blood cells, is a very rare but serious complication. We are aware of only a few reported cases in children. There appears to be no way to predict if a child will develop this condition. Frequent blood counts are expensive and painful and, besides, we have not found them useful.
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