Carbamazepine is a medication that is prescribed to prevent fits or seizures. It is therefore commonly used to treat epilepsy. Carbamazepine is also sometimes used to treat pain and help with mood disorders.
What is Carbamazepine?
- Carbamazepine is a common medication prescribed to treat epilepsy
- Carbamazepine is sometimes used to treat pain including the pain of trigeminal neuralgia, a pain arising from a nerve in the face
- Carbamazepine can also be used to help regulate the mood and feelings of people with bipolar disorder
- Carbamazepine is sometimes known by its brand names Tegretol and Curatil
- It is available as a tablet, liquid and as a suppository
- Carbamazepine can make you feel tired or sleepy. You must not drive or operate heavy machinery if this occurs
- It is important to read the patient leaflet for a full list of side effects and cautions.
How Does Carbamazepine Work?
In health, electrical signals fire within our brains as part of our normal cognitive function.
Epilepsy is a disease that is characterised by fits or seizures. These seizures are often the result of bursts of abnormal electrical activity occurring within the brain, that change the way the body behaves.
The change in electrical activity leads to changes in your muscles, emotions, sensations and behaviour, giving characteristic seizure activity. Some people also lose consciousness during a fit. Some seizures may be the jerking, tonic clonic seizures that are commonly recognised, or they may take the form of another type of seizure such as an absence seizure.
Carbamazepine works to stabilise the electrical activity occurring within the brain to prevent the seizures from happening.
When taken for the severe facial pain caused by trigeminal neuralgia, carbamazepine modifies the pain to make it more manageable.
Carbamazepine can also help to stabilise your mood if you have bipolar disorder, helping to minimise the extreme changes in mood and agitation you might experience.
How is Carbamazepine Taken?
Carbamazepine is most commonly taken in tablet form and is often take two or three times every day.
Prolonged release carbamazepine is available, which minimises the frequency with which the tablets need to be taken.
Tablets should be swallowed with some water, and they can be taken with or without food.
Carbamazepine is available as a liquid for those who find it difficult to take tablets. Carbamazepine is also available as a suppository for rectal use.
What is the proper dosage of Carbamazepine?
Carbamazepine 100mg / 200mg / 400mg
The initial dose of carbamazepine for epilepsy in adults is 100 to 200mg once or twice a day. This dose often needs to be slowly increased for the best response, and can go up to 1600mg to 2000mg each day to prevent seizure activity from occurring.
When treating the pain associated with trigeminal neuralgia, a common starting dose is 200mg to 400mg daily. This might be increased to 200mg 3 or 4 times daily to alleviate the pain.
To help stabilise the mood in bipolar disorder, at first 400mg is often split across two daily doses. A common long term dose is 400mg to 600mg divided across several doses, although this can be increased if required.
Are there any Side Effects to Carbamazepine?
Like all medications, carbamazepine can have some side effects. The most common side effects include:
- Feeling sleepy or dizzy
- Blurred or double vision
- Nausea and vomiting (feeling sick and being sick)
- Dry mouth
- Feeling unsteady
- Swollen feet
- Itchy skin.
If you feel sleepy, tired or dizzy, you must not drive or operate heavy machinery.
Carbamazepine can cause blood disorders which might increase your risk of infections. If you notice a fever, sore throat or swollen neck glands you should speak to your doctor. You should also consult a doctor if you notice mouth ulcers or unexplained bleeding or bruising.
If you have a severe allergic reaction (anaphylaxis) including breathlessness, lip or tongue swelling, call 999 immediately.
What warnings does Carbamazepine come with?
Carbamazepine may not be suitable for everyone. You should tell your doctor if you:
- Have heart block or an abnormal heart rhythm
- Have, or have ever had, bone marrow disease
- Have, or have ever had, porphyria
- Are pregnant, trying to conceive, or breastfeeding.
Some medications can interact with carbamazepine. You may be advised that carbamazepine will not suit you if you already take:
- A monoamine oxidase inhibitor (MAOI) – a type of anti-depressant
- Other antidepressants including amitriptyline, citalopram or mirtazapine
- Blood thinning medications including warfarin
- Heart or blood pressure medications
- Antibiotics or antifungals
- Medications for HIV.