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Carbamazepine
Indications
- Drug of choice for simple and complex partial seizures and tonic-clonic
seizures secondary to a focal discharge
- alternative to lithium
- rapid-cycling bipolar
disorder
Use
- Need to monitor FBC every 6 months
- unexplained sore throat may herald agranulocytosis
Mechanism of action and pharmacology
- Use dependant blocker of Na channels
- 100-200mg twice daily initially and then dose is increased until seizures
are controlled
- Therapeutic range is 4-12mg/L
Adverse effects
- Common but seldom severe, seen in 50% of patients with plasma levels over
8.5mg/L
- Sedation
- ataxia
- giddiness
- nystagmus
- diplopia
- blurred vision and slurred speech
- blood dyscrasias
- rashes
- interferes with oral contraceptives
- Side effects may be reduced by altering the timing of medication or using
modified release tablets
Contraindications
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