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In the United States, CBZ is approved by the FDA as monotherapy for the treatment of trigeminal neuralgia and complex partial, generalized tonic–clonic, and mixed seizure disorders ("Carbatrol" 2008; "Tegretol" 2008). OXC is approved for the treatment of partial seizures as monotherapy in adults and as adjunctive therapy in adults and children older than 4 years ("Trileptal" 2008). CBZ and OXC appear to have overlapping anticonvulsant effects, with similar efficacy in patients with newly diagnosed epilepsy (Dam et al. 1989). However, there may be dissociations. For example, switching to OXC may be effective in patients with inadequate responses or intolerable adverse effects with CBZ (Beydoun et al. 2000; Van Parys and Meinardi 1994), and adding OXC may yield efficacy in patients with inadequate responses to CBZ (Barcs et al. 2000; Glauser et al. 2000). In contrast to valproate and lamotrigine, which are approved first-line medications for bipolar disorder, CBZ and OXC are generally considered alternative agents in the management of bipolar disorder (American Psychiatric Association 2002), based on the studies reviewed below.

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Table Reference Number
TABLE 37–1. Carbamazepine (CBZ) and oxcarbazepine (OXC) in acute mania: 23 double-blind studies
Table Reference Number
TABLE 37–2. Carbamazepine (CBZ) in acute depression: four controlled studies
Table Reference Number
TABLE 37–3. Carbamazepine (CBZ) and oxcarbazepine (OXC) in prophylaxis of bipolar disorder: 16 controlled or quasi-controlled studies

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