Carbamazepine

Carbamazepine (sold under the brand-names Biston®, Calepsin®, Carbatrol®, Epitol®, Equetro®, Finlepsin®, Sirtal®, Stazepine®, Tegretol®, Telesmin®, Timonil®) is an anticonvulsant and mood stabilizing drug, used primarily in the treatment of epilepsy and bipolar disorder. It is also used to treat schizophrenia and trigeminal neuralgia. more...

Mechanisms

Carbamazepine and its derivatives' action mechanism is not well understood, but appears to be primarily through the inhibition of sodium channel activity.

Side-effects

Carbamazepine renders birth control pills ineffective.

Common side-effects include drowsiness, motor-coordination impairment and/or upset stomach. Taken every twelve hours, the Tegretol XR® or Carbatrol® preparations can greatly increase tolerability.

Less common side-effects include blurry or double vision and/or the temporary or mild loss of blood cells or platelets. In rare cases the latter can be life-threatening if unnoticed, so frequent blood tests are required during the first few months' use, followed by three or four tests per year. There are also reports of a bizarre auditory side-effect, whereby patients perceive musical notes about a semitone lower than their actual pitch (so middle C would be heard as the note B3 just below it, etc).

Oxcarbazepine, a derivative of carbamazepine, has fewer and less serious side-effects.

History

Carbamazepine was discovered by chemist Walter Schindler at J.R. Geigy AG (now part of Novartis) in Basel, Switzerland, in 1953. Schindler then synthesized the drug in 1960, before its anti-epileptic properties had been discovered.

Carbamazepine was first marketed as a drug to treat trigeminal neuralgia in 1962. It has been used as an anticonvulsant in the UK since 1965, but only approved in the U.S. since 1974.

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