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Carbamazepine

Carbamazepine is chemically similar to the tricyclic antidepressant drugs. It is most commonly used in the treatment of epilepsy, particularly partial seizures, where carbamazepine remains a first-line medication. Other uses include
- trigeminal neuralgia - bipolar disorder

Mechanism of action

  • binds to sodium channels increases their refractory period

Adverse effects

  • P450 enzyme inducer
  • dizziness and ataxia
  • drowsiness
  • headache
  • visual disturbances (especially diplopia)
  • Steven-Johnson syndrome
  • leucopenia and agranulocytosis
  • hyponatraemia secondary to syndrome of inappropriate ADH secretion

Carbamazepine is known to exhibit autoinduction, hence when patients start carbamazepine they may see a return of seizures after 3-4 weeks of treatment.

Quick comparison: Drug adverse effects

Hyponatraemia - carbamazepine - sulfonylureas - sodium valproate - thiazides - loop diuretics

Neuroleptic malignant syndrome - antipsychotics