Uses:
Carbamazepine
is used primarily in the treatment of acute mania and in the long
term control or prophylaxis of Manic Depressive Illness (Bipolar
Disorder).
It
is also used in the treatment of seizure disorders as well as
certain pain syndromes (e.g. trigeminal neuralgia)
Though
not approved for this indications, Carbamazepine has also been
found to be useful in the treatment of withdrawal reactions from
alcohol or sedatives/hypnotics, and in the behavior disturbances,
such as chronic aggression or impulsivity.
How
does the doctor decide what dose (how many milligrams) to
prescribe?
The
dose of carbamazepine is different for every patient and is based
on how much carbamazepine is in the blood, as well as the response
to treatment. The doctor will measure the drug level in the blood
on a regular basis during the first few months. The carbamazepine
level that is usually found to be effective for most patients is
between 17 and 50mmol/l(4-12m/ml)
You
may initially take take your
medication several times a day(2 or 3); after several weeks, the
doctor may decide to prescribe the drug daily.
On
the morning of your blood test, take the morning dose of
carbamazepine after the test to avoid inaccurate results.
How
quickly will the drug start working?
Control
of manic symptoms will require up to 14 days of treatment. Because
carbamazepine takes time ti work, do not increase or decrease the
dose or stop the medication without discussing this with your
doctor. Improvement in seizures, pain symptoms as well as
aggression/ impulsivity also occur gradually.
How
long should you take this medication?
Following
the first episode of mania it is recommended that carbamazepine be
continued for a minimum of one year; this decreases the chance of
being ill again.The doctor may then decrease the drug slowly and
moniter for any symptoms; if none occur, the drug can gradually be
stopped. For individuals who have had several episodes of mania or
depression, carbamazepine should be continued indefinitely. Long
term treatment is generally recommended for recurring depression,
seizure disorder and aggression/ impulsivity.
Side
effects
Side
effects occur, to some degree, with all medication. They are
usually not serious and do not occur in all individuals. They may
sometimes occur before beneficial effects of the medication
is noticed. If a side effect continues, speak to your doctor about
appropriate treatment.
Common
side effects that should be reported to your doctor at the next
appointment include:
-
Drowsiness
and lethargy, difficulty concentrating-This problem goes away
with time. Use of other drugs that make you drowsy will worsen
the problem. Avoid driving a car or operating machinery if
drowsiness persists.
-
Dizziness-Get
up from a lying or sitting position slowly; dangle your legs
over the edge of the bed for a few minutes before getting up.
Sit or lie down if dizziness persists or if you feel
faint-then call a doctor.
-
Ataxia
or unsteadiness-Discuss this with your doctor as this may
require an adjustment in your dosage.
-
Blurred
vision-This usually occurs a t the star of treatment and tends
to be temporary. Reading under a bright light or at a distance
may help; a magnifying glass can be of temporary use. If the
problem continues, advise your doctor.
-
Dry
mouth-Sour candy and sugarless gum help increase saliva in
your mouth; try to avoid ,sweet calorie-laden beverages. Drink
water and brush your teeth regularly.
-
Nausea
or heartburn-If this happens take the medication with food. If
vomiting or diarrhea occur and persist for more than 24 hours,
call your doctor.
-
Muscle
tremor-Speak to your doctor as this may require an adjustment
in your dosage.
-
Change
in sex drive or sexual performance-Discuss this with your
doctor.
-
Weight
changes-monitor your food intake; avoid foods with high fat
content (e.g. cakes and pastry)
Rare
side effects that you should report
your doctor immediately include:
-
Soreness
of the mouth, gums, or throat, mouth lesions
-
Skin
rash or itching swelling of the face
-
Nausea
,vomiting, loss of appetite, lethargy, weakness, fever, or
flu-like symptom
-
Easy
bruising, bleeding, appearance of splotchy purplish darkening
of the skin
-
Confusion
or disorientation
Let
your doctor know if you miss your period or suspect you may be
pregnant.
What
should you do if you forget to take a dose of your medication?
If
you take your total dose of carbamazepine and you forget to take
it for more than 6 hours, skip the missed dose and continue with
your regular schedule.
Interactions
with other medication
Because
carbamazepine can change the effect of other medication, or may be
affected by other medication, always check with your doctor or
pharmacist before taking other drugs, including over-the–counter
medication such as cold remedies. Always inform any doctor or
dentist that you see that you are taking this drug.
Precautions
-
Do
not increase or decrease your dose without consulting your
doctor.
-
Avoid
drinking grapefruit juice while on carbamazepine as it can
effect the level of carbamazepine in your body.
-
If
you are on liquid carbamazepine ,do not mix it with any other
medication.
-
This
drug may impair the mental and physical
abilities and reaction time required for driving a car
or operating machinery. Avoid these activities if you feel
drowsy or slowed down
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