Tegretol for Bipolar (Carbamazepine)

by Sarah from Bipolar-Lives
(US)

US BRAND NAME: Tegretol

GENERIC NAME: Carbamazepine

TYPE: Anticonvulsant

USE: Tegretol is used to control seizures in the treatment of epilepsy, and is also used in the treatment of bipolar disorder (manic-depressive illness). It is FDA-approved for the treatment of manic and mixed episodes of bipolar I disorder.

COMMENTS: Dr Jim Phelps suggests Tegretol may be a good choice for patients with rapid cycling, or severe sleep problems. It may also appeal if you don't want to risk weight gain on Depakote (especially for women), or if you can't afford Trileptal and need the stronger option anyway. Points in Tegretol's favor are that it has a long history of use, although mainly an anti-manic it does seem to have some antidepressant effects, it is cheap, and it does not cause substantial weight gain.

EVIDENCE: Randomized trials provide evidence of efficicacy, although it does not have as much supporting research behind it as lithium or Depakote. About 2 in 5 people with mania get improvement with Tegretol, compared with a 1 in 5 who take a pretend treatment (a placebo). The evidence for it as an antidepressant is not as strong. One review found that carbamazepine worked as well as lithium, but another found it did not work any better than a pretend treatment (a placebo).

SIDE EFFECTS: Include but not limited to: drowsiness, blurred vision, headaches and migraines, motor coordination impairment, upset stomach, increased sensitivity to alcohol.

CAUTIONS: Tegretol can undermine the effectiveness of oral contraceptives (birth control pills) containing estrogen. This could result in an unplanned pregnancy so use a different or additional means of birth control. If you do become pregnant when taking Tegretol you should talk to your doctor immediately as this drug may harm the fetus.