Carbamazepine is a drug belonging to the group of anticonvulsants that serves precisely to treat seizures, as well as nerve pain in cases of diabetic neuropathy and trigeminal neuralgia. It works by reducing nerve impulses that cause seizures and pain.

This medicine is also used to treat patients with bipolar disorder . Carbamazepine is eutimizing, that is, it is a mood stabilizer . In addition to the aforementioned uses, it also serves to treat patients with epilepsy, schizophrenia, manic, petit mal or other ailments associated with nerves.

Uses of carbamazepine

Its uses are directly associated with diseases caused by altered electrical activity in the brain. In this sense, it is used for the treatment of mental illnesses, restless legs syndrome, depression, some pain syndromes and a disease that affects children called ‘chorea’. We invite you to know what it can and cannot be used for:

For sleeping

Although one of the side effects caused by this drug is drowsiness, it does not mean that it is used directly to sleep. Its action is aimed at controlling seizures and other symptoms in people with some mental disorders. Therefore, this drug should not be used to induce or fall asleep.

For withdrawal from drug treatment

It is not necessarily a drug to get high. On the contrary, it is prescribed in emergency cases to treat drug or alcohol withdrawal syndrome with the purpose of stopping certain neuronal activities. Regarding the use of this drug to reduce dependence on cocaine, for example, it does not show effectiveness, but causes adverse effects.

For back pain

It is not indicated for the treatment of back pain, in fact, for any common pain. In any case, it is used for pains of nervous origin caused by diabetic neuropathy and trigeminal neuralgia. The important thing is that the medication with this drug is always supervised by a specialist.

For diabetes

This drug is often prescribed to those patients suffering from diabetes insipidus and the painful complications of the disease in general. In the same way it is indicated to treat diabetic neuropathy. Studies carried out in patients with this condition to whom carbamazepine was administered for a period of 10 months, showed a significant decrease in pain.

What does Carbamazepine relieve?

Anticonvulsant drugs do not directly cure the diseases for which they are prescribed, but rather they are used to control these clinical pictures. This drug is regularly indicated alone or in combination with another for the control of certain types of seizures in epileptic people, in the same way it is indicated for trigeminal neuralgia.

In the case of prolonged-release capsules, they attack episodes of frantic moods, in which the patient is abnormally irritated or excited, or mixed episodes in which the symptoms of mania and depression occur at the same time. They also work for patients with bipolar I disorder. Other conditions that are treated with this drug are:

  • Posttraumatic stress
  • Schizophrenia
  • Tabes dorsal
  • Typical absences (petit mal)
  • Glossopharyngeal neuralgia
  • Certain types of depression
  • Senile dementia aggression

Mechanism of action

The actual mechanism of action of this drug has not yet been determined. However, it is known to act by stabilizing hyperexcited nerve membranes, inhibiting neuronal discharges, and decreasing synaptic transmission of excitatory impulses.

In this sense, its mechanism of action would be focused on the prevention of repetitive discharges of sodium-dependent action potentials in depolarized neurons in use, blocking the voltage-dependent sodium channels. The antiepileptic effects of the drug are due to the decrease in glutamate and the stability of neuronal membranes.

On the other hand, the antipsychotic effects come from the reduction in the production of norepinephrine and dopamine. Thus, pain relief is due to blockage of synapse transmission in the nucleus of the trigeminal nerve. This drug is characterized by having sedative, anticholinergic, muscle relaxant, anti-arrhythmic and neuromuscular blocking properties.

Posology

The important thing when starting treatment with this medicine is to follow the indications given by the doctor as is, who will determine the correct dose according to the disease and when it should be increased or decreased. However, here are some recommendations regarding dosage:

Partial seizures (simple or complex) or generalized tonic-clonic seizures

For adults and adolescents the initial dose will be 200mg / day divided into two doses. Progressively this dose will be increased by 200mg per day at intervals during the week until the corresponding maximum doses are reached, which would be 3-4 administrations.

In children 6 to 12 years old, 100mg twice a day will be started by mouth. Thereafter it will increase to 100mg per day at weekly intervals until the maximum response is reached. In children under 6 years it will be 10-20mg initially, in 2 or 4 doses. It will be increased at intervals until the optimal dose is reached.

Neuropathic pain (diabetic neuropathy)

The starting dose will be 100mg twice a day. It will be progressively increased to 600-800mg per day or until intolerable adverse effects for the patient arise.

Neuropathic pain (postherpetic neuralgia)

According to a study carried out with 77 patients, it is suggested to combine this drug with fluphenazine or amitriptyline, in doses of 100-300 mg for 3 times a day.

Neuropathic pain (trigeminal neuralgia)

The starting dose begins with 100 mg twice a day, which can be gradually increased with increases of 100 mg every 12 hours until relief of symptoms is experienced. The maximum dose should not exceed 1200mg per day.

Bipolar disorders (including the early phase of mania and depression)

For adults and adolescents the initial dose will be 200mg / day in two administrations. It will be increased with intervals of 3-4 days until the plasma concentration of 8-12 µg / ml is reached.

Recommendations for administering the medication

  • For extended-release tablets or capsules , take it whole (do not crush, open, or break).
  • The chewable tablets should be chewed before swallowing.
  • For oral suspension , the dose should be measured with the syringe or measuring device. A homemade spoon should not be used.
  • Try to eat with food
  • Frequently, medical tests are required during treatment.
  • In case the medicine is not having the correct effect (avoid seizures, for example), consult a doctor immediately.
  • Store it at room temperature, avoiding exposure to moisture, light and heat.
  • Even if you notice improvement before finishing the treatment or attending the doctor’s appointment, do not stop suddenly, as seizures could increase.

Carbamazepine Side Effects

These are some of the side effects that have been reported in patients treated with this drug:

  • Uncontrollable shaking in any part of the body.
  • Abnormal thoughts, dizziness.
  • Constipation.
  • Difficulty articulating words.
  • Dry mouth.
  • Confusion. Feeling weak and tired
  • Loss of appetite, nausea, vomiting.
  • Fatigue, vision changes.
  • Jaundice on the skin
  • Dark colored urine.
  • Difficulty swallowing or breathing.
  • Ringing in the ears.
  • Pain located in the right area of ​​the stomach.
  • Slow, fast, or strong heartbeat. Irritability.
  • Mild to severe rash.
  • Swelling of the face, lips, tongue, or eyes.
  • Headache, trouble concentrating, increased seizures.

Contraindications

Its use should be avoided in patients who have a history of bone marrow depression, intermittent water porphyria, drug hypersensitivity, myasthenia gravis, or sensitivity to tricyclic compounds such as imipramine, amitriptyline, protriptyline, desipramine, or nortriptyline.

Likewise, it should not be administered with monoamine oxidase (MAO) inhibitors, and if treatment with carbamazepine is necessary, the inhibitors should be suspended for a minimum of 14 days or longer if possible.

In case of overdose

These are some of the symptoms that a patient with an overdose of this drug may experience:

  • Restlessness, seizures, loss of consciousness.
  • Uncontrollable shaking in any area of ​​the body.
  • Loss of balance, dizziness, drowsiness.
  • Muscle spasms. Changes in sight
  • Alteration of heart rate and breathing.
  • Difficulty urinating.
  • Nausea, vomiting

conclusion

Before consuming any drug, especially those used to treat mental or nervous clinical conditions, special care must be taken to follow the indications given by the specialist, as an increase or decrease in the dose could trigger consequences even greater than disease being treated.

Samantha Robson
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Dr. Samantha Robson ( CRN: 0510146-5) is a nutritionist and website content reviewer related to her area of ​​expertise. With a postgraduate degree in Nutrition from The University of Arizona, she is a specialist in Sports Nutrition from Oxford University and is also a member of the International Society of Sports Nutrition.

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