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Excerpt 2
John H. Greist, MD and James W. Jefferson, MD

Carbamazepine & Bipolar Disorder: A Guide

(Excerpt 2)

How should carbamazepine be taken?
A doctor familiar with carbamazepine use is best able to determine how much carbamazepine is needed and how often it should be taken. Since the proper dose varies among individuals, patients are advised to follow the directions on the prescription label. They should never hesitate, however, to ask their doctor or pharmacist any question about dosage directions. To minimize side effects, doctors will often start new patients on a low dose and gradually increase it until the desired effect is obtained. Later, the dose may again be adjusted with the goal of finding the "minimal effective dose" (i.e., the least amount of drug needed to obtain the desired effect).

Carbamazepine is usually taken in divided doses over the course of the day—usually 2 to 4 times daily. The extended-release formulations available in the U.S. and Canada allow the drug to enter the body more gradually and, therefore, are suitable for twice daily dosing. Both Carbatrol and Equetro brands are capsules that can be swallowed whole or that may be opened and sprinkled over food. Tegretol-XR and Tegretol-CR are coated tablets that must be swallowed whole and never crushed or chewed.