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Carbamazepine

Carbamazepine is a prescription medication in the dibenzazepine family and is sold under a variety of brand names.  It is typically available as chewable tablets, extended-release tablets and capsules and as a liquid suspension.  Patients usually begin with a low dose of carbamazepine and are tapered up to the full recommended dosage over time; the same precautions should be used when discontinuing the use of carbamazepine to avoid unwanted side effects and withdrawal symptoms.  Carbamazepine can provide effective pain relief for patients suffering from chronic back pain due to spinal disorders or other serious conditions of the upper or lower back.

Uses for Carbamazepine

First discovered in 1953, carbamazepine was initially used to treat a condition called trigeminal neuralgia, a brain disorder that causes intense pain in the face and jaw.  The medication was highly effective in treating this neural condition and provided significant relief for patients, often allowing them to resume regular activities once more.  Today, carbamazepine is often prescribed for spinal injuries and disorders and may be incorporated into pain management strategies for a number of diseases and medical conditions, including:

 

•             Multiple sclerosis

•             Diabetic neuropathy

•             Restless leg syndrome

•             Amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease

•             Lupus

•             Guillain-Barré syndrome

•             Certain types of cancer

 

In addition, carbamazepine is an anti-convulsant and is often prescribed for patients suffering from epilepsy to help prevent seizures and allow improved control over their disease.  Carbemazepine may also be used to treat bipolar disorder and depression due to its effect on neural firing patterns within the brain; by reducing the intensity and frequency of neural activity, it can reduce the effects of these neurochemical disorders.  The medication is used to treat symptoms of disease on an ongoing basis and is not a permanent cure.

Contraindications for Carbamazepine use

Carbamazepine is not recommended for patients with bone marrow suppression, a side-effect of chemotherapy treatments and other medications that significantly impact the immune system.  Patients with known allergies to antidepressants should not use carbamazepine.  Additionally, physicians may weigh the benefits of carbamazepine against its risks when prescribing it for patients with:

•             High blood pressure

•             Glaucoma

•             Lupus

•             Liver or kidney disease

•             Porphyria

•             Heart disease

•             Thyroid disease

Pregnant women may continue the use of carbamazepine to maintain seizure control, but it is not generally recommended for other uses during pregnancy due to increased risk of developmental issues and spina bifida in the unborn child.  Additionally, carbamazepine should be avoided by individuals of Asian ancestry due to the possibility of Stevens-Johnson syndrome, a serious allergic rash that may be life-threatening in extreme cases.

Known Drug Interactions

Carbamazepine interacts with a number of other drugs and may amplify or reduce the effectiveness of these medications.  Patients should avoid using herbal remedies or over-the-counter medications while taking carbamazepine unless specifically instructed to do so by their physician.  Other medications that interact with carbamazepine include, but are not limited to:

 

•             Antidepressants, including Elavil, Celexa and Prozac

•             Acetaminophen

•             Antibiotics including erythromycin, clarithromycin and clonazepam

•             Seizure control medications

•             Blood thinning agents including Coumadin

•             Methadone

•             Saint John’s Wort

•             Lithium

•             Claritin

•             Certain HIV protease inhibitors

This is not a comprehensive list of carbamazepine’s drug interactions. Patients should advise their physicians of all medications currently taken; this includes vitamins, minerals and herbal supplements as well as traditional prescription and over-the-counter medications.

Side effects of Carbamazepine

Carbamazepine may cause a number of minor side effects including:

•             Mild diarrhea

•             Nausea and vomiting

•             Constipation

•             Sleepiness or fatigue

•             Dry mouth

•             Headache

These typically improve as the patient’s body adjusts to the drug.  Serious side effects may include:

•             Chest pain

•             Psychological disturbances

•             Vision changes

•             Disorientation or confusion

•             Jaundice, specifically yellowing of the skin and of the whites of the eyes

Any serious side effects should be reported to the patient’s physician immediately.

Carbamazepine is a prescription medication and should only be taken under medical supervision. Patients should discuss their treatment plans with their attending physicians in order to ensure the most beneficial course of treatment for their particular needs.