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Research
News . . . .
Oxcarbazepine (continued)
Five recent studies4-8 suggest positive
effects of open-label OXC in bipolar and related disorders, primarily as an
adjunctive medication
(see table).
Together, these 18 studies and case reports have generated interest in using OXC in those patients who have
adverse side effect reactions to CBZ.
III.
Does OXC Have Any Adverse Side Effects?
Common adverse side effects reported with OXC are skin
eruption (rash), hyponatremia (decrease in sodium levels), dizziness,
vertigo, sleepiness, headache, ataxia (unsteadiness), and vomiting.
Unlike CBZ, OXC is not a potent inducer of the cytochrome P450 family
and does not cause interactions with many other drugs such as anticoagulants, thyroid
hormones, and antibiotics; it does, however, induce the metabolism of
estrogen which necessitates the use of high dosage forms of oral contraceptives. OXC
levels do not rise markedly when combined with verapamil or erythromycin, as
they do when combined with CBZ.
IV. What
About OXC Dosages?
The equivalent dose of OXC to
CBZ is approximately 1.5 times that of CBZ. OXC is more expensive than CBZ. OXC is
available as 150 mg, 300 mg, and 600 mg tablets, and as a 300 mg oral
suspension. It is eliminated from the body rather quickly, but OXC can
be administered twice daily.
For the variety of reasons given above, OXC
may come to play a role in the treatment
of bipolar disorders in the future. We hope to see further controlled trials
of OXC in the literature.
4 Alvarez G, Marsh W, Camacho IA,
Gracia SL (2003). Effectiveness and tolerability of carbamazepine vs.
oxcarbazepine as mood stabilizers. Clin Res Reg Affairs 20: 365-372.
5 Benedetti A, Lattanzi L, Pini S, Musetti L, Dell'Osso L,
Cassano GB (2004). Oxcarbazepine as add-on treatment in patients with
bipolar manic, mixed or depressive episode. J Affect.Disord 79:
273-277.
6 Centorrino F, Albert MJ, Berry JM, Kelleher JP, Fellman V, Line
G, Koukopoulos AE, Kidwell JE, Fogarty KV, Baldessarini RJ (2003).
Oxcarbazepine: clinical experience with hospitalized psychiatric patients.
Bipolar Disord 5: 370-374.
7 Ghaemi SN, Berv DA, Klugman J, Rosenquist KJ, Hsu DJ (2003).
Oxcarbazepine treatment of bipolar disorder. J Clin Psychiatry 64:
943-945.
8 Raja M, Azzoni A (2003). Oxcarbazepine vs. valproate in the
treatment of mood and schizoaffective disorders. Int J
Neuropsychopharmacol 6: 409-414.
The following report was compiled by Mr.
Chris Gavin.
Revised 07/01/04
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