Letter to the Editor

Oxcarbazepine Treatment of Refractory Bipolar Illness

Authors: Tricia G. Majczenko, MD, Jonathan T. Stewart, MD


To the Editor:

Numerous studies over the past 25 years have demonstrated the efficacy of carbamazepine in bipolar illness.1 Unfortunately, carbamazepine can be a difficult medication to use, due to significant drug-drug interactions, laborious titration related to enzyme autoinduction (both due to induction of the cytochrome P450 system), potential for agranulocytosis and hyponatremia.

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1. Hirschfeld RMA, Kasper S. A review of the evidence for carbamazepine and oxcarbazepine in the treatment of bipolar disorder. Int J Neuropsychopharmacol 2004;7:507–522.
2. Bazil CW. Antiseizure drugs. In Noseworthy JH (ed). Neurological Therapeutics: Principles and Practice. London, Martin Dunitz, 2003; pp. 297–307.
3. Emrich HM, Altmann H, Dose M, et al. Therapeutic effects of GABA-ergic drugs in affective disorders: a preliminary report. Pharmacol Biochem Behav 1983;19:369–372.
4. Emrich HM, Dose M, von Zerssen D. The use of sodium valproate, carbamazepine and oxcarbazepine in patients with affective disorders. J Affect Disord 1985;8:243–250.
5. Emrich HM. Studies with (Trileptal) oxcarbazepine in acute mania. Int Clin Psychopharmacol 1990;5:83–88.