LYCOS RETRIEVER 
Carbamazepine
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Carbamazepine (CAR-buh-MAZ-uh-peen) is the generic name (non-brand name) of a widely used type of seizure medicine. Brand names for carbamazepine in the United States include Tegretol and Carbatrol. In other countries, carbamazepine is known by other brand names, such as Carbagen SR, Mazepine, Tegrital, Teril, and Timonil.
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Carbamazepine is a dangerous drug if an extreme overdose is taken; death has been known to happen after very large overdoses. On the other hand, any drug is toxic when overdosed. If carbamazepine is used under a doctor's care, it is as safe as any other antiepileptic drugs. This does not mean that it is entirely harmless. The side effects can be unpleasant. When the treatment is begun, the side effects can include drowsiness, fatigue, dizziness, or nausea.
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Lithium & Carbamazepine: #16 average difference after 1 year: 31 patients who were stable on lithium had half switched to carbamazepine in a DB for one year. There was a 9# weight gain on lithium vs. 7# loss on carbamazepine. Relapses occurred in 6 on carbamazepine and 8 on lithium, but most on carbamazepine occurred near the beginning suggesting withdrawal effect. Carbamazepine versus lithium in the prophylaxis of bipolar affective disorder. Coxhead N, Silverstone T, Cookson J. Acta Psychiatr Scand 1992 Feb;85(2):114-8
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Carbamazepine has been noted to have a variety of interactions with other medications. The use of carbamazepine in combination with oral anticoagulants, contraceptives, or doxycycline, decreased the effectiveness of these medications by the probable induction of microsomal enzymes by carbamazepine. When taken with propoxyphene or troleandomycin, an increased carbamazepine effect has been noted, probably due to inhibition of microsomal enzymes by those drugs.3
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Carbamazepine distribution and metabolism are complex. It is reasonably bioavailable and rapidly absorbed from the gastrointestinal tract, leading to peak drug concentrations in 1 to 3 hours. Carbamazepine is highly bound to plasma proteins (75-80%) with moderately large volume of distribution and has a half-life between 12 and 20 hours. Hepatic metabolism is the major route of elimination, with renal excretion accounting for only 1% to 3% of its elimination. When patients are started on carbamazepine, hepatic cytochrome p450 (CYP3A4) induction occurs over 2 to 3 weeks. This induction reduces the plasma half-life of the drug from 25 to 65 hours to 12 to 20 hours.
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Carbamazepine may exhibit side effects to the nervous system, for example, drowsiness, dizziness, blurred vision, unsteadiness, depression, impaired concentration, and headache. Patients should be cautious about operating machinery or performing tasks requiring alertness until tolerant of the side effects. After several weeks of treatment, these side effects may disappear. To minimize these side effects, doctors may start carbamazepine at a low dose and may recommend that it be taken before bedtime. As carbamazepine may cause stomach upset and nausea, the medicine should be taken with meals.
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Carbamazepine