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Carbamazepine-
- Seizures:
- Partial and secondary generalized tonic-clonic seizures.
- Primary generalized tonic-clonic seizures.
- Trigeminal Neuralgia: Effective for pain relief.
- Bipolar Disorder: Used as prophylaxis.
- Acts by stabilizing hyperactive neuronal activity, possibly via sodium channel modulation.
- Stimulates antidiuretic hormone (ADH) release and enhances water reabsorption.
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✅ Description:
Carbamazepine inhibits activity in the thalamic nucleus ventralis, limits synaptic propagation of excitatory impulses, and diminishes the summation of temporal stimuli leading to neuronal discharge by reducing the influx of Na ions across the cell membrane, among other processes. It increases the secretion of antidiuretic hormone (ADH) and enhances its ability to promote water reabsorption.
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✔️ Uses:
- Epilepsy/Seizures
- Trigeminal neuralgia
✔️ Dosage & Administration
Epilepsy:
- Adults/Children over 12 years:
- Initial: 200 mg twice daily, gradually increasing.
- Maintenance: Typically 800-1200 mg/day.
- Children (6-12 years):
- Initial: 100 mg twice daily, gradually increasing.
- Maintenance: 400-800 mg/day.
- Children under 6 years: Dosing based on weight (10-20 mg/kg/day).
Trigeminal Neuralgia:
- Initial: 100 mg twice daily.
- Maintenance: 400-800 mg/day (max 1200 mg/day).
✔️ Side Effects:
- Frequent: Drowsiness, dizziness, nausea, vomiting, unsteadiness.
- Rare/Serious: Skin rash, aplastic anemia, liver issues, cardiovascular problems.
- May increase sensitivity to sunlight—use sunscreen or protective clothing.
✔️ Contraindications
- Allergy to carbamazepine or tricyclic antidepressants.
- History of:
- Atrioventricular block.
- Bone marrow depression.
- Porphyria.
- Recent use of MAOIs (within 14 days).
✔️ Pregnancy & Lactation
- Category D: Risk of fetal harm; use only if benefits outweigh risks.
- Transferred to breast milk—may require discontinuation of breastfeeding.
✔️ Precautions
- Avoid abrupt discontinuation; taper off gradually under medical supervision.
- Use caution with:
- Elderly patients.
- History of liver, kidney, or heart disease.
- Blood disorders or glaucoma.
- Hormonal contraceptives may become ineffective—use non-hormonal methods.
✔️ Storage
- Keep at temperatures below 30°C, away from light and moisture.
- Store safely out of children’s reach.
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