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Chapter 37. Carbamazepine and Oxcarbazepine

Terence A. Ketter, M.D.; Po W. Wang, M.D.; Robert M. Post, M.D.
DOI: 10.1176/appi.books.9781585623860.419522

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Excerpt

Pharmacotherapy of bipolar disorder is a complex and rapidly evolving field. The development of new treatments has helped to refine concepts of illness subtypes and generated important new management options. Although the mood stabilizers—the first-line agents lithium, valproate, and lamotrigine and the alternative agents carbamazepine (CBZ) and oxcarbazepine (OXC)—are considered the primary medications for bipolar disorder, antipsychotics, antidepressants, anxiolytics, and a new generation of anticonvulsants are commonly combined with mood stabilizers in clinical settings (American Psychiatric Association 2002; Ketter 2005; Suppes et al. 2005). These diverse medications have varying pharmacodynamics, pharmacokinetics, drug–drug interactions, and adverse effects, thus offering not only new therapeutic opportunities but also a variety of new potential pitfalls.

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CME Activity

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Sample questions:
1.
The main metabolic pathway of carbamazepine is mediated primarily through which of the following cytochrome P450 (CYP) enzyme systems?
2.
What is the major difference in oxcarbazepine’s metabolism in comparison with carbamazepine’s metabolism?
3.
Recent research has found that the risk of developing a serious rash with carbamazepine may be much higher in certain populations. Which patient population should be genetically tested before starting carbamazepine?
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Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
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