Carbamazepine is an aromatic anticonvulsant that is widely used in therapy of epilepsy and trigeminal neuralgia.
Liver safety of Carbamazepine
Carbamazepine is a well established cause of clinically apparent liver injury which can be severe and even fatal.
Mechanism of action of Carbamazepine
Carbamazepine (kar" ba maz' e peen) is an iminostilbene that is chemically related to tricyclic antidepressants and unrelated in structure to other anticonvulsants. Carbamazepine suppresses spread of seizure activity by reduction in the post-tetanic potentiation of synaptic transmission.
FDA approval information for Carbamazepine
Carbamazepine was approved for use in epilepsy in the United States in 1968 and it is still in common use with more than 2 million prescriptions being written yearly.
Clinical use of Carbamazepine
Current indications include prevention and management of partial, complex, mixed and generalized seizures. It is used alone or in combination with other anticonvulsants. Carbamazepine is also effective in trigeminal neuralgia and peripheral neuropathies, but the mechanisms of its analgesic actions are not known. Carbamazepine is used off label for behavioral disorders and depression.
Dosage and administration for Carbamazepine
Tablets of 100 mg and 200 mg and extended release capsules of 100, 200 and 400 mg are available, as are liquid formations and chewable forms for use in pediatrics. Carbamazepine is available in multiple generic forms and under the commercial names as Tegretol, Carbatrol, Equetro and Epitol. The recommended starting dose in adults for seizures is 200 mg twice daily or 100 mg four times daily, with increase in dose by 100 to 200 mg at weekly intervals based upon clinical response, but generally not exceeding 1200 mg daily. Doses in children are based upon body weight. Typically, lower doses are used for trigeminal neuralgia and other less established indications (restless leg syndrome, bipolar disorders, chorea).
Side effects of Carbamazepine
Frequent side effects include drowsiness, sedation, ataxia, blurred vision, nausea, vomiting, and skin rash.