Carbamazepine for epilepsy

Examples

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Brand Name	Chemical Name
Tegretol-XR	carbamazepine

Tegretol requires 2 to 4 doses each day. It comes in liquid, tablet, and chewable tablet forms.

Carbatrol and Tegretol-XR are new extended-release forms of carbamazepine. They require two doses each day.

How It Works

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Carbamazepine prevents seizures by calming the electrical activity in the brain.

Why It Is Used

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Carbamazepine is the medication of choice for children who have partial seizures and one of the drugs of choice for treating adults who have partial seizures. It may also be used to control generalized tonic-clonic seizures.

People who have absence seizures or myoclonic seizures probably should not use carbamazepine. It does not prevent these types of seizures and can even make them worse.

How Well It Works

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Carbamazepine is effective in preventing all three types of partial seizures.¹

Carbamazepine may not interfere with your ability to think clearly (cognitive impairment) as much as some other drugs used to treat epilepsy, such as phenytoin.

Side Effects

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Common side effects of carbamazepine include:

• Dizziness.
• Drowsiness.
• Headache.
• Double vision and blurry vision.
• Nausea.
• Decreased coordination.

Taking smaller but more frequent doses of carbamazepine may reduce its side effects. High doses of carbamazepine can affect a person's thinking and state of mind, but this can often be avoided.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

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It may take time and careful, controlled adjustments by you and your doctor to find the combination, schedule, and dosing of medication to best manage your epilepsy. The goal is to prevent seizures while causing as few unwanted side effects as possible. Regular blood tests help monitor the amount of medication in your blood; it is important to maintain a consistent dose. Once the most effective medication program is determined, it is important that you follow it exactly as prescribed.

• Adverse effects. Some of carbamazepine's long-term effects may not be fully known yet. People tend to tolerate the drug quite well, and it has fewer side effects than phenobarbital, another drug used to treat the same types of seizures.
• Serious health risks. High levels of carbamazepine can cause serious, but uncommon, side effects such as liver problems, bone marrow problems (low blood counts), and skin rash. Using carbamazepine without other antiepileptic drugs lowers the risk of these problems. Regular blood tests can also lower the risk by identifying any problems early on.
• Risk of birth defects. Some experts feel use of the drug during the early stages of pregnancy can increase the risk of the birth defects spina bifida and anencephaly.
• Other concerns. Carbamazepine may reduce the effectiveness of birth control pills.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. Brodie M, Kwan P (2002). Staged approach to epilepsy management. Neurology, 58(8, Suppl 5): S2–S8.

Credits

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Author	Monica Rhodes
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman
Primary Medical Reviewer	Michael J. Sexton, MD - Pediatrics
Specialist Medical Reviewer	Steven C. Schachter, MD - Neurology
Last Updated	November 11, 2005