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What is Carbamazepine

What is Carbamazepine? It is an antiepileptic drug (dibenzazepine derivative) that also has normotensive, antimanic, antidiuretic (in patients with non-sugar diabetes), and analgesic (in patients with neuralgia) effects.

Pharmacological action

The mechanism of action is associated with blockade of potential-dependent Na+-channels, resulting in stabilization of the neuronal membrane, inhibition of the occurrence of serial discharges of neurons and reduction of synaptic conduction of impulses. Prevents the reformation of Na+-dependent action potentials in depolarized neurons. Reduces the release of the excitatory neurotransmitter amino acid glutamate, increases the reduced seizure threshold and thus reduces the risk of an epileptic seizure. Increases conductance for K+, modulates potential-dependent Ca2+ channels, which may also determine the anticonvulsant effect of the drug. Corrects epileptic personality changes and, eventually, increases patients’ communicability and contributes to their social rehabilitation. 

It can be prescribed as the main therapeutic drug and in combination with other anticonvulsant drugs. It is effective in focal (partial) epileptic seizures (simple and complex), accompanied or not accompanied by secondary generalization, in generalized tonic-clonic epileptic seizures, as well as in combination of these types.

In patients with epilepsy (especially in children and adolescents) there is a positive effect on symptoms of anxiety and depression, as well as reduced irritability and aggressiveness. The effect on cognitive function and psychomotor parameters depends on the dose and is highly variable. The onset of anticonvulsant effects varies from several hours to several days (sometimes up to 1 month due to autoinduction of metabolism). In essential and secondary trigeminal neuralgia, it prevents the occurrence of painful attacks in most cases. There are not enough data on carbamazepine pharmacokinetics in patients with renal or hepatic impairment.

Indications for carbamazepine

Epilepsy (excluding absences, myoclonic or flaccid seizures) – partial seizures with complex and simple symptoms, primary and secondary generalized forms of seizures with tonic-clonic convulsions, mixed seizure forms (monotherapy or in combination with other anticonvulsants); idiopathic trigeminal neuralgia, trigeminal neuralgia in multiple sclerosis, idiopathic lingual pharyngeal neuralgia, alcohol withdrawal syndrome, treatment of affective disorders, polydipsia and polyuria in diabetes mellitus, pain syndrome in diabetic polyneuropathy. Prevention of phasic affective disorders (manic-depressive psychosis, schizoaffective disorders, etc.).