Term
| How successful is carbamazepine in the treatement of acute mania? |
|
Definition
| 50-70% response seen in 2-3 weeks |
|
|
Term
| In which 3 groups of patients is carbamazepine especially effective as bipolar prophylaxis? |
|
Definition
Bipolar II
Schizoaffective disorder
Dysphoric mania |
|
|
Term
| What are the 4 indications of carbamazepine in psychiatry? |
|
Definition
1. Mania
2. Prophylaxis
3. Refractory depression
4. Control of aggression in patients with schizophrenia or schizoaffective disorder |
|
|
Term
| Does carbamazepine cause weight gain? |
|
Definition
|
|
Term
| What is the frequency of blood dyscrasias in carbamazepine therapy? |
|
Definition
Aplastic anemia or agranulocytosis - 1:125,000
Leukopenia - 1-2% |
|
|
Term
| Are patients treated with carbamazepine who develop leukopenia at a higher risk for blood dyscrasias? |
|
Definition
|
|
Term
| What lab interferences does carbamazepine cause? |
|
Definition
Hepatitis - cholestatic or hepatocellular
If aminotransferases are >x3 of UPN - discontinue |
|
|
Term
| What percentage of patients treated with carbamazepine develop a skin rash? |
|
Definition
| 10-15% - benign maculopapular rash |
|
|
Term
| What are the 4 severe dermatological reactions to carbamazepine therapy? |
|
Definition
Stevens-Johnson syndrome
Exfoliative dermatitis
Erythema multiforme
Toxic epidermal necrolysis |
|
|
Term
| What are the renal effects of carbamazepine? |
|
Definition
| Hyponatremia (SIAD-like effect), especially in the elderly |
|
|
Term
| Which 5 conditions are relative CI to carbamazepine therapy? |
|
Definition
Glaucoma
Prostatic hypertrophy
Diabetes
History of alcohol abuse
Pregnancy |
|
|
Term
| What are the 3 major drug interactions with carbamazepine? |
|
Definition
1. MAOIs - 2 week washout period
2. Contraceptives - reduced levels, breakthrough bleeding, uncertain pregnancy prevention
3. Valproate - lower dose of carbamazepine, increase dose of valproate |
|
|
Term
| Are adverse effect more or less common in oxcarbazepine (compared to carbamazepine)? |
|
Definition
↓ risk of blood dyscrasias (no need for monitoring)
↓ risk of benign rash, serious rashes are rare. 25-30% of patients who develop a rash to carbamazepine, develop the same rash in oxcarbazepine
↑ risk of hyponatremia (3-5%) |
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