We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
Published online by Cambridge University Press: 06 October 2020
THERAPEUTICS
Brands
• Tegretol, Carbatrol, Tegretol XR, Equetro, Teril, Timonil, Carbagen, Arbil, Epimaz, Mazepine, Novo-Carbamaz
Generic?
• Yes
Class
• Antiepileptic drug (AED)
Commonly Prescribed for
(FDA approved in bold)
• Complex partial seizures with or without secondary generalization (adults and children, monotherapy and adjunctive)
• Generalized tonic-clonic seizures
• Mixed seizure patterns (except absence seizures, juvenile myoclonic epilepsy)
• Trigeminal neuralgia
• Bipolar I disorder (acute manic and mixed episodes)
• Glossopharyngeal neuralgia
• Lennox-Gastaut syndrome
• Neuropathic pain
• Alcohol withdrawal
• Restless leg syndrome
• Psychosis/schizophrenia (adjunctive)
How the Drug Works
• Blocks voltage-dependent sodium channels
• Modulates sodium and calcium (L type) channels and NMDA glutamate transmission
How Long Until It Works
• Seizures: 2 weeks or less
• Trigeminal neuralgia or neuropathic pain: hours to weeks
• Mania: weeks
If It Works
• Seizures: goal is the remission of seizures. Continue as long as effective and well tolerated. Consider tapering and slowly stopping after 2 years without seizures, depending on the type of epilepsy
• Trigeminal neuralgia: should dramatically reduce or eliminate attacks, pain may recur. Periodically attempt to reduce to lowest effective dose or discontinue
If It Doesn't Work
• Increase to highest tolerated dose. Subject to autoinduction, meaning that dose requirements can change over time
• Epilepsy: consider changing to another agent, adding a second agent, using a medical device, or a referral for epilepsy surgery evaluation. When adding a second agent, keep drug interactions in mind. Check level if compliance is in question
• Trigeminal neuralgia: try an alternative agent. For truly refractory patients referral to tertiary headache center, consider surgical or other procedures
Best Augmenting Combos for Partial Response or Treatment-Resistance
• Epilepsy: drug interactions can complicate multi-drug therapy
• Pain: can combine with other AEDs (gabapentin or pregabalin) or TCAs
To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Find out more about the Kindle Personal Document Service.
To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.
To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.
