Carbamazepine: Uses and Side Effects

One of the most commonly used medications in the treatment of seizures is carbamazepine. However, it can cause mulsystemic damage if the recommended dose is exceeded.

Psychiatric drugs are used in the treatment of psychiatric and nervous system pathologies. Within this group of drugs, there’s a group called antiepileptic drugs, which are used to treat seizures. Carbamazepine belongs to this group, but what are its uses and side effects?

Epilepsy is one of the most common disorders in the area of neurology. This condition creates abnormal activity in the brain that causes seizures in most cases. Epilepsy can also lead to abnormal behavior, unusual sensations, and a loss of consciousness.

Unfortunately, this is a very common neurological problem and studies claim that it affects between 2% and 4% of the general population. However, there’s a wide variety of medication that can control the symptoms suffered by these people and reduce their impact on their daily lives.

What is carbamazepine?

Carbamazepine is indicated in patients with epilepsy.
This medicine is commonly used in patients with epilepsy.

As mentioned before, carbamazepine belongs to the group of antiepileptic drugs, which is used in the control of seizures and other psychiatric conditions. This compound has a great distribution capacity throughout the body, from cerebrospinal fluid to saliva and breast milk.

Among the population group that uses the drug the most, children stand out, however, the side effects it produces in them can be more severe. In this sense, it’s vitally important to maintain strict control of the plasma levels of the drug to avoid their appearance.

Carbamazepine is available in a wide variety of forms, each of which can be used to treat different conditions. In this way, it’s possible to find tablets, chewable tablets, extended-release, and suspension tablets, all of which have a very varied dosage.

What’s it for?

The drug in question is useful in the treatment of partial and tonic-clonic seizures, that is, those that can cause severe muscle spasms and loss of consciousness. These are usually one of the most characteristic and severe symptoms of epilepsy.

On the other hand, carbamazepine is the first-choice treatment for trigeminal nerve neuralgia and glossopharyngeal nerve neuralgia. These pathologies involve inflammation of the fifth and ninth cranial nerves respectively, which produces acute pain of severe intensity.

This drug can also help in the treatment of the following pathologies:

Mechanism of action of the drug

This drug’s mechanism of action hasn’t yet been fully explained. However, carbamazepine is known to decrease the release of glutamate from nerve endings, an excitatory neurotransmitter in the central nervous system (CNS).

The decrease in the release of the neurotransmitter will generate a stabilization of the neuronal membranes, which may explain its antiepileptic effect. The compound also decreases the release of other neurotransmitters such as dopamine and norepinephrine, which explains its antipsychotic effect.

On the other hand, carbamazepine inhibits synaptic transmission in the trigeminal nucleus, which helps reduce pain in neuralgia. Lastly, the drug has anticholinergic, muscle relaxant, antiarrhythmic, and sedative properties.

How do you take carbamazepine?

This drug’s form of ingestion will depend on the form of presentation you use. Generally speaking, 2-4 doses of the drug should be taken a day, preferably during or after each meal. However, it’s important not to exceed the dose recommended by the specialist.

According to the drug’s internal package insert, the initial dose of the compound may vary depending on the disease to be treated. For patients with epilepsy, the starting dose is between 100 and 200 milligrams, a maximum of twice a day.

For adults, the dose of the drug can be increased to between 800 and 1200 milligrams a day. In children, the dosage can be a maximum of 400 or 600 milligrams a day, depending on the child’s weight.

When treating neuralgia, the usual dose ranges from 200 to 400 milligrams daily, however, the dose can be increased until the pain subsides. Finally, the usual dose for the treatment of mania is between 400 and 600 milligrams a day.

Side effects

As with all marketed drugs, carbamazepine can cause certain adverse effects. However, they’re transitory, non-limiting, and disappear after a few days, so they don’t usually interfere with the performance of daily activities.

Among the most frequent secondary symptoms associated with the consumption of this drug, the following stand out:

  • A loss of muscle coordination
  • Dizziness
  • Drowsiness
  • Fatigue
  • Allergic skin reactions
  • Lesions on the skin
  • Headaches

Research shows that side effects in children don’t differ much from those in adults. The most common side effects in this age group are drowsiness, loss of coordination, and vertigo. However, they can also develop severe dermatological, hematological, and liver disorders.

Warning and contraindications

Carbamazepine should not be consumed in pregnancy.
Pregnant women should not take carbamazepine.

Carbamazepine is totally contraindicated in those patients who have any type of allergy to the active ingredient or to any of the excipients. In addition, it’s also contraindicated in those with cardiovascular diseases or with a history of severe hematological diseases.

This medicine is safe for both children and older adults, however, a doctor should be consulted as the dose may need to be readjusted.

Pregnant or lactating women should consult their doctor before ingesting this medication. It’s distributed throughout all the tissues in the body and can affect the baby significantly. The drug is capable of causing birth defects such as spina bifida, and skull and face malformations.

It’s also important to inform the specialist if you’re taking other types of medications, especially if they’re psychotropic drugs. This will avoid a potentially harmful drug interaction. Finally, be aware of any symptoms that indicate damage to any specific organ.

Carbamazepine: a drug with some side effects

Carbamazepine is a very useful medicine in the treatment of seizures and other psychiatric conditions. It’s very safe in most cases, even in children and the elderly. However, its indiscriminate consumption can cause damage to important organs such as the liver and pancreas.

In this sense, it’s vitally important to consume it only under medical supervision, and following the precise instructions provided by the specialist. If you observe any unfavorable symptoms that don’t disappear after a few days, you’ll need to consult your doctor to rule out any serious complications.

  • Figueroa Duarte A, Campell Araujo Ó. Aspectos psicosociales de la epilepsia. Arch. Neurocien. (Mex., D.F.) 2004; 9( 3 ): 135-142.
  • Mennickent S, Vega M, Godoy C, León D. Relación entre niveles de carbamazepina en saliva y plasma: Estudio piloto. Rev. méd. Chile. 2007; 135( 3 ): 335-340.
  • Agencia Española de Medicamento y Productos Sanitarios. Prospecto interno: Carbamazepina 200 mg comprimidos EFG. Documento disponible en: https://cima.aemps.es/cima/dochtml/p/62620/P_62620.html#introducci-n.
  • Beydoun A, DuPont S, Zhou D, Matta M, Nagire V, Lagae L. Current role of carbamazepine and oxcarbazepine in the management of epilepsy. Seizure. 2020 Dec;83:251-263.
  • Djordjevic N, Jankovic SM, Milovanovic JR. Pharmacokinetics and Pharmacogenetics of Carbamazepine in Children. Eur J Drug Metab Pharmacokinet. 2017 Oct;42(5):729-744.
  • Gierbolini J, Giarratano M, Benbadis SR. Carbamazepine-related antiepileptic drugs for the treatment of epilepsy – a comparative review. Expert Opin Pharmacother. 2016;17(7):885-8.