Seizure Disorders and Trigeminal Neuralgia | Acute Mania | Acute Depression | Prophylaxis | Response Predictors
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.