Tegretol

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

Mechanisms

The mechanism of action of carbamazepine and its derivatives 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. A temporary or mild loss of blood cells or platelets is also possible, and in rare cases can be life-threatening if unnoticed so frequent simple blood tests are required for the first few months followed by three or four a year to detect them. Use of carbamazepine can result in blurry or doubled vision.

For people with bothersome side effects such as nausea, Tegretol XR® or Carbatrol® taken every 12 hours can greatly increase tolerability.

There are reports of a bizarre auditory side effect, whereby patients perceive musical notes about a semitone lower than they truly are. (Middle C would be heard as a B.)

Oxcarbazepine is a derivative of carbamazepine which has fewer and less serious side effects.

History

Carbamazepine was discovered at Geigy in Basel in 1953 by a chemist named Walter Schindler, who also synthesized the drug in 1960. The drug's anti-epileptic properties were discovered later. 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 US in 1974.

Reference

• Schindler W, Häfliger F. Über derivate des iminodibenzyls. Helv Chim Acta 1954;37:472-483.

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