What Meds

Psychiatric Medications


Oxcarbazepine
Brand Name: Trileptal

Overview
Trileptal is the brand name for oxcarbazepine, an anti-convulsant and therefore anti-epileptic drug. It is similar in structure to Tegretol (carbamazepine), another anti-convulsant. The exact mechanism by which Trileptal works is not known, but it is thought to modulate certain ion channels in neurons, stabilizing hyperexcited neurons in the brain. Trileptal can be taken with or without food.

This drug has been tested in children as young as 3 years old, and is considered effective therapy for seizures in patients 3-17 years old, as well as in adults. Trileptal is effective in both adjunct and monotherapy in the treatement of seizures.

Trileptal was FDA approved in January 2000.

Why is this drug prescribed?
Trileptal is FDA-approved for treatment of partial seizures in adults and children over the age of 4, and for adjunctive treatment of partial seizures in adults and children over the age of 2.

Trileptal is used to treat seizures due to epilepsy. It is also being investigated as a possible treatment for mania in patients with bipolar disorder.

How much of this drug is typically used?
Tablets: 150 mg, 300 mg, 600 mg
Suspension: 300 mg/5 mL

Warnings and Precautions
Hyponatremia: in some patients, a condition of low sodium (salt) levels in the blood may occur, called hyponatremia. Blood sodium levels should be monitored in those who take Trileptal for a long time, and in some cases, the doctor may recommend reducing fluid intake to keep sodium levels more balanced. Symptoms of hyponatremia include headache, nausea, and confusion.

As with any anti-seizure medication, Trileptal dosage should be tapered gradually when it is discontinued. Sudden discontinuation has a high risk of increased seizure frequency.

Trileptal can cause drowsiness and dizziness. Patients taking Trileptal should not drive or operate heavy machinery until the Trileptal’s effects are known and do not impair functioning.

Birth control: hormonal contraceptives may be less effective when taken with Trileptal.

For Pregnant or Nursing Mothers: Trileptal has not been studied in pregnant women, but studies in animals indicate that it is very likely to cause birth defects. Trileptal is similar to Tegretol, a drug which is known to cause birth defects, and therefore Trileptal is expected to have similar effects during pregnancy. Trileptal is passed into breast milk, and nursing while taking Trileptal is not advised.

Contraindications
Trileptal should Not be used for people with an allergy or hypersensitivity to Trileptal. Also, patients should remember that hypersensitivity to the related drug Tegretol (carbamazepine) increases the chance of hypersensitivity to Trileptal.

Precautions
Trileptal may be used with caution in people with the following conditions:

Adverse Reactions
Trileptal may cause the following reactions:

Rarely:

Adverse reactions are similar in both children and adults.

Interactions with Drugs and Other Substances
Drugs or substances that may interact with Trileptal include:

Research Studies and Use in Child Psychiatry
There is very little evidence to support the use of oxcarbazepine in child psychiatry.  One large study in children and adolescents with bipolar disorder found that it did not treat mania any better than placebo. Furthermore, similar studies in adults with bipolar disorder have been negative. However, it is stil sometimes used to treat children with bipolar disorder when other first- and second-line medications have failed.

Sources

Stanford Medicine Resources:

Footer Links: