In a mixed exposure, a measured carbamazepine concentration may explain only part of the clinical picture. Hirsch and colleagues examined records from 80 adults with elevated carbamazepine concentrations to look for factors associated with severe neurologic symptoms.
What the adjusted analysis found
In this selected hospital series, reported antidepressant or benzodiazepine exposure was associated with severe neurologic findings after adjustment for whether carbamazepine concentration exceeded 30 micrograms per millilitre. The researchers analyzed ICU admission separately. The predictors for admission differed from the predictors for severe neurologic findings.
How to interpret the concentration in a case
The study was retrospective and recorded co-exposures from clinical records. An association can support reviewing the other medications without assigning each drug a fixed share of the effect. Align specimen times with symptoms, treatments and the known or suspected timing of every exposure. The cutoff used in this analysis does not establish an individual severity threshold.
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