LYCOS RETRIEVER 
Carbamazepine: Treatments
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Lithium + Carbamazepine = Lithium + Haldol: In a DB 8-week study of manics after two week wash-out in hospital, there was no difference in efficacy at 8 weeks between lithium with carbamazepine compared to lithium plus haldol. Authors favor lithium-carbamazepine because of fewer neurological side-effects. Indiana U. Lithium combined with carbamazepine or haloperidol in the treatment of mania. Small JG, Klapper MH, Marhenke JD, Milstein V, Woodham GC, Kellams JJ. Psychopharmacol Bull 1995;31(2):265-72
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Carbamazepine is FDA-approved for treatment of epilepsy, mania/bipolar disorder, and neuropathic pain. SJS and TEN are serious blistering reactions of the skin and mucous membranes that can be permanently disabling or fatal.
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Lithium = Carbamazepine in Small DB Bipolar II: 57 pts 2 ½ yr f/u randomized. Lithium averaged 960 mg/d, Carbamazepine 630mg/d. Hospitalization carbamazepine 17%, lithium 33% not signif difference. 2/3 free of recurrences. Greil W, Kleindienst N: Lithium vsersus barbamazepine in the maintenance treatment of bipolar II disorder and bipolar disorder not otherwise specified. Int Clin Psychoph 99;14:283-5, U Munich.
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Carbamazepine (CBZ) has been widely used for treatment of manic states. Because amphetamine produces effects in humans similar to those of idiopathic mania, acute methamphetamine administration could serve as a model of this condition. To elucidate the neurobiological substrates responsible for the antimanic effects of carbamazepine, this study investigated the effects of chronic carbamazepine administration on regional Fos protein expression induced by a single dose of methamphetamine (2mg/kg). Chronic treatment with CBZ (0.25% in food for 7 days, followed by 0.5% for 7 days; final mean serum carbamazepine concentration: 4.09 ± 0.34 g/ml) significantly attenuated the number of Fos-like immunoreactivity-positive nuclei induced by methamphetamine administration in the core of the nucleus accumbens and the caudate/putamen. The results indicate these brain regions are involved in the antimanic effects of carbamazepine.
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Carbamazepine can be substituted for or combined with lithium for a success-ful treatment of manic-depressive psychoses. It has proved equally effective as benzodiazepines in the therapy of alcohol withdrawal syndrome. Carbamazepine is effective on diabetes insipidus thanks to its antidiuretic properties.
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