Oxcarbazepine is sold under the brand name "Trileptal".
Oxcarbazepine is an antiepileptic medication that is not approved by the FDA for use in Bipolar Disorder. Studies of its use in Bipolar Disorder have been published in Europe and in the USA. Its favorable side effect profile along with solid study support has led to its routine use in the treatment of Bipolar Disorder. It is approved for use in certain kinds of seizures in adults and children as young as 4 years old.
Oxcarbazepine appears to reduce the pathological release of glutamate by blocking the depolarization of a particular class of voltage dependent sodium channel.
Oxcarbazepine tends to be more effective for the manic and mixed than the depressed phases of Bipolar Disorder. It is therefore often combined with a mood elevating medication, e.g. lamotrigine or bupropion, to provide good support against both mania and depression. In more difficult to treat manias it may be combined with lithium, valproic acid, atypical antipsychotics, and other mood stabilizers.
The adverse effect profile of oxcarbazepine is quite good compared to other mood stabilizing medications. It can cause some initial nausea and drowsiness that improves with time and is minimized by starting the medication at a low dose and advancing the dose slowly. Up to 15% of people who take oxcarbazepine can develop abnormally low sodium levels that are sometimes associated with fatigue, mild depression, difficulty thinking and even difficulty walking. It can also be associated with headaches and clumsiness. It does not tend to cause weight gain and when taken consistently over time has limited effect on cognitive function.
Oxcarbazepine can increase the elimination of hormones taken in birth control pills. Dr. Hoopes recommends that women of childbearing age work closely with the physician prescribing her birth control to ensure that levels are adequate for contraception. He also recommends the additional use of barrier methods of birth control while taking Trileptal.
Like other antiepileptics used in psychiatry, it can be associated with a serious rash known as Stevens-Johnson Syndrome. If you develop a rash taking oxcarbazepine call Dr. Hoopes's office right away for an urgent appointment.
Oxcarbazepine may be associated with birth defects (a closely related antiepileptic, carbamazepine, certainly has been associated with neural tube defects). If you think you may be pregnant, call the office right away for an appointment to discuss the options in pregnancy. Dr. Hoopes recommends that women of childbearing age take prenatal vitamins that include folic acid while taking oxcarbazepine.
If you miss a dose of oxcarbazepine do not add the missed dose to the next dose. As will all other medications, take oxcarbazepine regularly as prescribed.
