Carbamazepine dose-concentration relationship in elderly nursing home residents

Angela K. Birnbaum, Jeannine M. Conway, Nancy A. Hardie, Thomas E. Lackner, Sandra E. Bowers, Ilo E. Leppik

Research output: Contribution to journalArticle

8 Scopus citations


Purpose: To describe the dose-concentration relationships of carbamazepine (CBZ) in elderly nursing home residents and the effect of sex, age, and type of co-medications. Results: This is a cross-sectional study of elderly (≥65 years) nursing home residents across the United States (N = 92). Data collection was from 1 June 1998 to 31 December 2000. The mean CBZ dose was 9.2 ± 5.4 mg/(kg day-1) (±Standard Deviation) and serum concentration was 5.9 ± 2.2 mg/L. The daily dose was significantly lower in the oldest-old age group (≥85 years, mean 476.9 mg/day (95% confidence interval CI) 326.5-627.3) as compared to the dose in the young-old (65-74 years, mean 724.4 mg/day (CI) 603.4-845.4) (p = 0.016). Adjusted for body weight, doses were similar on a mg/(kg day-1) basis. The majority of observed CBZ serum concentrations were at the lower end (67.4%) or below (20.7%) the suggested therapeutic range for younger adult outpatients. Conclusions: Total daily CBZ doses and patient weight decreased with age. The average dose for elderly nursing home residents was approximately 9 mg/(kg day-1). Carbamazepine serum concentrations were lower than those used for younger adults, suggesting that these patients may be more sensitive to CBZ.

Original languageEnglish (US)
Pages (from-to)31-35
Number of pages5
JournalEpilepsy Research
Issue number1
StatePublished - Oct 1 2007


  • AED
  • Carbamazepine
  • Elderly
  • Epilepsy
  • Nursing home

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