Anticonvulsant
Blocks voltage-gated sodium channels, stabilizing neuronal membranes and reducing repetitive firing.
Partial seizures, generalized tonic-clonic seizures, trigeminal neuralgia, bipolar disorder (acute mania and maintenance)
Neuropathic pain, restless leg syndrome (RLS), agitation and aggression in traumatic brain injury (TBI), agitation and aggression in neurodevelopmental disabilities, post-stroke aggression, dementia-related agitation and psychosis
Tablets, extended-release tablets, chewable tablets, oral suspension
200 mg p.o. twice daily, titrated as clinically indicated
400–1200 mg/day
Autoinduction occurs within 3–5 weeks, shortening half-life from ~36 hours initially to 10–20 hours at steady state; metabolized primarily by CYP3A4 and induces multiple CYP enzymes
Dizziness, somnolence, nausea, headache, hyponatremia
Stevens-Johnson syndrome, agranulocytosis, aplastic anemia, hepatic toxicity
Serum carbamazepine levels (therapeutic range 4–12 μg/mL), liver function tests, CBC with differential, serum sodium, particularly during titration and periodically every 6–12 months
Serious dermatologic reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis), aplastic anemia, agranulocytosis
Use cautiously in elderly patients and those with dementia due to sedative effects and increased fall risk. Dose adjustments may be necessary in hepatic or renal impairment. In individuals with developmental disabilities, careful monitoring is advised given potential for sedation and drug interactions, especially when combined with other medications.