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James W. Jefferson, MD, John H. Greist, MD and David J. Katzelnick, MD

Oxcarbazepine & Bipolar Disorder: A Guide

(Excerpt 1)

What is oxcarbazepine? Oxcarbazepine (pronounced ox-Kar-BAZE-a-peen) (brand name Trileptal) is a medication developed initially as a treatment for certain types of epilepsy. It was first approved in the United States by the Food and Drug Administration (FDA) in January for use either by itself or with other drugs to treat partial seizures in adults with epilepsy and for use with other drugs to treat partial seizures in children ages 4-16 with epilepsy. While there are currently no FDA-approved indications for oxcarbazepine in psychiatry, early research studies and current clinical experience support its value in some patients with bipolar disorder (manic-depressive disorder) who fail to respond satisfactorily to or tolerate other treatments such as lithium (Eskalith, Lithobid, lithium carbonate and others) and divalproex (Depakote). Oxcarbazepine may be used in combination with other medications or by itself.

Despite its recent appearance in the U.S., oxcarbazepine is really an old drug. It was synthesized , studied in Europe in and marketed first in Denmark for epilepsy. Since then it has become available for that indication in more than 60 countries worldwide. It is related in many ways to carbamazepine (Carbatrol, Tegretol and others), a drug available in the United States to treat certain forms of epilepsy and certain types of facial pain.

Oxcarbazepine is taken by mouth in the form of tablets which require a doctor�s prescription. It is supplied as 150 mg, 300 mg and 600 mg film-coated tablets, all of which are scored so they can easily be broken in half. Oxcarbazepine is also known by its brand name, Trileptal. It has been approved in Canada for treating epilepsy but, at the time of this writing, it is not yet available. There are currently no generic preparations available in the United States.