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Psychiatry Clin Neurosci. 2001 Aug;55(4):423-6.

Severe, isolated thrombocytopenia under polytherapy with carbamazepine and valproate.

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  • 1Ludwig Boltzmann Institute for Research in Epilepsy and Neuromuscular Disorders, Postfach 348, 1180 Vienna, Austria.


It is not known whether polytherapy with carbamazepine (CBZ) and valproate (VPA) increases the risk of thrombocytopenia. A 67-year-old woman with symptomatic epilepsy since age 6 years, classified as Lennox-Gasteau syndrome, developed severe, isolated thrombocytopenia of 5 GIGA/L (normal: 150-360 GIGA/L) after being on CBZ (1200 mg/day) for 15 days and additional VPA (300 mg/day) for 5 days in combination. After discontinuation of CBZ and VPA and two thrombocyte transfusions, the thrombocyte count normalized within 3 days. Because she had been taking VPA for only 5 days in addition to CBZ, it could not be confirmed whether it was CBZ alone or the combination of CBZ and VPA that was responsible for the severe thrombocytopenia.

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