Carbamazepine is an anticonvulsant used to treat epilepsy and trigeminal neuralgia, and as a mood stabilizer for bipolar disorder.
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Dr. Steve Malen, PharmD
Dr. Steven Blikstein, PharmD
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Carbamazepine (Tegretol) is an anticonvulsant that works by blocking sodium channels in the brain, stabilizing overactive nerve cells. It is used to treat partial and generalized tonic-clonic seizures, trigeminal neuralgia (a severe facial nerve pain condition), and as a mood stabilizer for acute manic and mixed episodes of bipolar I disorder. Dosing varies by indication and is typically started low and titrated gradually, often in the range of 400-1200 mg per day in divided doses. Common side effects include dizziness, drowsiness, nausea, and unsteadiness (ataxia). Carbamazepine carries boxed warnings for serious, potentially fatal skin reactions (Stevens-Johnson syndrome and toxic epidermal necrolysis), which occur more frequently in patients with a specific genetic marker (HLA-B*1502) found predominantly in patients of Asian ancestry; genetic testing is recommended before starting therapy in at-risk populations. It also carries a boxed warning for aplastic anemia and agranulocytosis (serious blood cell disorders), requiring baseline and periodic blood count monitoring. Carbamazepine is a strong inducer of liver enzymes and can significantly reduce the effectiveness of many other medications, including hormonal contraceptives.
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Carbamazepine is an anticonvulsant used to treat seizures, trigeminal neuralgia, and as a mood stabilizer for bipolar disorder. It works by blocking sodium channels in the brain to calm overactive nerve activity.
Boxed warnings: Carbamazepine can cause serious, potentially fatal skin reactions (Stevens-Johnson syndrome and toxic epidermal necrolysis), which occur more often in patients with the HLA-B*1502 genetic marker, found predominantly in people of Asian ancestry. Genetic testing is recommended before starting therapy in at-risk patients. Carbamazepine can also cause aplastic anemia and agranulocytosis, serious blood disorders that require baseline and periodic blood count monitoring.
Common side effects include dizziness, drowsiness, nausea, and unsteadiness.
Carbamazepine strongly induces liver enzymes and can reduce the effectiveness of many other medications, including hormonal birth control.