How Does Trileptal Work For Bipolar

Types Of Mood Stabilizing Medication

The oldest and most studied of mood stabilizers is lithium. However, many drugs that were first developed as anticonvulsants to treat epilepsy also act as mood stabilizers. These include carbamazepine, divalproex and lamotrigine. Gabapentin and topiramate are also anticonvulsants that may act as mood stabilizers, but they are usually given in addition to other medications.

Lithium

Lithium is found in nature in some mineral waters and is also present in small amounts in the human body.

Lithium is used to treat mania and to prevent further episodes of mania and depression.

Common side-effects of lithium include increased thirst and urination, nausea, weight gain and a fine trembling of the hands. Less common side-effects can include tiredness, vomiting and diarrhea, blurred vision, impaired memory, difficulty concentrating, skin changes and slight muscle weakness. These effects are generally mild and fade as treatment continues. If, however, any of these effects are severe, they should be reported to your doctor immediately. Thyroid and kidney function can be affected by lithium in some people and must be monitored regularly by your doctor.

Changing the amount of salt you use can also affect lithium levels: avoid switching to low- or no-salt diets.

Signs that the amount of lithium in the body is higher than it should be include severe nausea, vomiting and diarrhea, shaking and twitching, loss of balance, slurred speech, double vision and weakness.

Carbamazepine

Lamotrigine

Serum Levels Of The Major Trileptal Metabolite

A blood test is available to monitor the serum level of MHD , but the clinical value of this measurement is uncertain. At this point the blood test might be useful to ensure that an adolescent is taking the medicationmore of a measurement of compliance, so to speak, whereas dosing is better guided by clinical response and tolerability by individuals.

Studies In Comorbid Disorders

Lamotrigine has been suggested as effective in the treatment of comorbid bipolar and borderline personality disorder , comorbid bipolar disorder and alcohol dependence , and comorbid bipolar disorder and cocaine dependence . However, these studies all have limited methodological rigor that impact on the validity of their findings.

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Comparison Of Two Forms Of Oxcarbazepine For The Treatment Of Bipolar Depression

This study will use the CCI Engaged Practice platform and will be conducted by a central “meta-site” reviewing eligibility, obtaining consent, randomizing subjects to treatment groups, training local care providers to function as sub- investigators and monitoring outcomes.

Subjects will be randomized to six weeks of treatment with extended release oxcarbazepine or immediate release oxcarbazepine,while remaining under the care of their existing LCP.

LCP’s will receive sub-investigator training for Good Clinical Practice, Human subjects protection, and all protocol specified assessments and procedures.

Trileptal Is A Medication Known As An Anticonvulsant That Is Used To Treat Seizures And Sometimes The Symptoms Of Bipolar Disorder

Article by:

• Kathleen Smith, PhD, LPC

What is Trileptal?Trileptal is a medication known as an anticonvulsant that is used to treat seizures. It is also sometimes used as a mood stabilizer to treat the symptoms of bipolar disorder.

When did the U.S. Food and Drug Administration approve the medication?Trileptal was first approved by the FDA in 2001.

Is there a generic version of Trileptal?Yes, the generic version is known as oxcarbazepine and is sold in the U.S.

Are there any major differences between Trileptal and other medications used to treat bipolar disorder?Trileptal belongs to the class of medications known as anticonvulsants. Anticonvulsants are sometimes prescribed to treat manic episodes associated with bipolar disorder. Trileptal may be prescribed in combination with other medications to treat symptoms. Talk to your doctor about the potential risks and benefits of taking Trileptal.

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Prevent Relapse: Dont Stop

Once you have responded to medication treatment, it is important to continue taking your medication as prescribed. In general, it is necessary for individuals with bipolar disorder to continue taking mood stabilizing medications for extended periods of time .

Discontinuing treatment earlier may lead to a relapse of symptoms. If you have had a number of episodes of mania or depression, your doctor may recommend longer-term treatment. If episodes of mania or depression occur while on mood stabilizers, your doctor may add other medications to be taken for shorter periods of time.

To prevent symptoms from returning or worsening, do not abruptly stop taking your medications, even if you are feeling better, as this may result in a relapse. You should only stop taking your medication under your doctors supervision. If you want to stop taking your medication, talk to your doctor about how to correctly stop.

How To Take And Store

Trileptal can be taken with or without food. You may find it easier to swallow the pill with water. Trileptal in liquid form and pill form should be stored in a cool, dry placeâthey do not need to be refrigerated.

If you miss a dose of Trileptal, simply take another dose as close as possible to the time you were scheduled to take it. Be sure not to take more than you’re prescribed. If you’re forgetting many doses or haven’t been able to take it at a consistent time each day, discuss this with your health care provider.

If you take more than you are prescribed, you may experience an increase in negative side effects such as dizziness, drowsiness, and/or vomiting. Though overdoses from Trileptal are rare, it’s best to contact your doctor if you experience these or other effects.

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Rated For Seizures Report

I have been on this drug for 14 1/2 yrs. The first 12 were a breeze. Now, out of the blue, if there is a side effect, I AM HAVING IT! Oh my gosh, get me off of it. My insurance changed so I can’t see my regular neurologist anymore. Finally found a new one however she can’t see me for three months! My hair is falling out in handfuls, I have been to the E.R. twice for low sodium, my migraines have increased in frequency and strength, my TSH has fallen from 1.89 to 1.4 in the space of a year , anxiety through the roof, my stomach hurts, I have become “stupid” , insomnia every night, liver enzymes have gone from 30 to 76 in just two years etc. My primary doctor wants me off of it because of my liver but she isn’t a neurologist so I don’t want to go off until I have had an EEG and know how much to taper off. I read the horror stories about the side effects of coming off of it and honestly, I am scared…but this cannot go on. If I knew how to start safely, I would do it now.

Oxcarbazepine May Cause Side Effects Tell Your Doctor If Any Of These Symptoms Are Severe Or Do Not Go Away:

• fast, repeating eye movements that you cannot control
• diarrhea
• changes in the way food tastes
• dry mouth
• weight gain
• headache
• shaking of a part of the body that you cannot control; difficulty coordinating movements; falling down
• slowed movements or thoughts; forgetfulness, difficulty concentrating, and speech problems
• back, arm, or leg pain
• muscle weakness or sudden tightness
• increased sweating
• swelling, redness, irritation, burning, or itching of the vagina, white vaginal discharge

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Information On Trileptal For Bipolar Disorder:

Oxcarbazepine – brand name Trileptal – is an anticonvulsant closely related to Carbamazepine, which has a variety of brand names, including Tegretol. Oxcarbazepine is 10,11-Dihydro-10-oxo-5H-dibenzazepine-5-carboxamide. Oxcarbazepine is a white to faintly orange crystalline powder. It is slightly soluble in chloroform, dichloromethane, acetone, and methanol and practically insoluble in ethanol, ether and water. Its molecular weight is 252.27.

Trileptal is currently FDA-approved only for use in treating certain types of seizure disorders. However, for many years, this drug has been used in Europe as a mood-stabilizer for patients with bipolar disorder.

Dosage Forms & Strengths

Trileptal

• Initial: 8-10 mg/kg/day PO divided q12hr; not to exceed 600 mg/day
• <20 kg: May consider starting with 16-20 mg/kg/day; may titrate to higher dose over 2-4 weeks; not to exceed 60 mg/kg/day

Trileptal

• Initial: 8-10 mg/kg/day PO divided q12hr; not to exceed 600 mg/day
• Target maintenance dose: May titrate to higher dose over 2 weeks to reach the following dosage ranges
• 20-29 kg: 450 mg PO q12hr
• 29.1-39 kg: 600 mg PO q12hr
• >39 kg: 900 mg PO q12hr

Oxtellar XR

• Initial: 8-10 mg/kg PO qDay; not to exceed 600 mg/day in the first week

• Target maintenance dose

• May titrate to higher dose at weekly intervals in 8-10 mg/kg/day increments to reach the following target maintenance dosage ranges over 2-3 weeks
• 20-29 kg: 900 mg PO qDay
• >29-39 kg: 1200 mg PO qDay
• >39 kg: 1800 mg PO qDay

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Rated For Bipolar I Disorder Report

One hour after taking my 3rd, 600mg dose for Bipolar I, my vision blurred, my speech was slurred and as I tried to walk my body gave way and I hit the floor hard. I layed there in a fog. My husband carried me to bed. It has a two hour half life so those effects wore off quickly. I feel that is what a stroke would’ve been like, had it been one. Scary medicine and I recommend caution when taking it. Driving and walking on stairs needs to be addressed before you even start.

Why Is This Medication Prescribed

Oxcarbazepine is used alone or in combination with other medications to control certain types of seizures in adults and children. Oxcarbazepine extended-release tablets are used in combination with other medications to control certain types of seizures in adults and children 6 years of age and older. Oxcarbazepine is in a class of medications called anticonvulsants. It works by decreasing abnormal electrical activity in the brain.

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Oxcarbazepine For Acute Affective Episodes Of Bipolar Disorder

People with bipolar disorder suffer from repeated episodes of severe mood disturbance. These can vary from mania to severe depression. ;Sometimes manic and depressive symptoms can occur at the same time. Episodes may also fluctuate frequently, so-called ‘rapid-cycling’. Periods of normal mood and function may occur in between these episodes, but this is not always the case.

Medications are used to treat these mood episodes and to prevent their recurrence. Oxcarbazepine could be one such medication. Currently, it is only licensed for the treatment of epilepsy.

In this review we found seven studies that were eligible for inclusion, of which four studies compared the efficacy of oxcarbazepine to placebo or to other medications used in treating mania. While there was no evidence that oxcarbazepine worked better compared to a placebo, it did have similar efficacy to more accepted medications for the treatment of the illness.

Two studies examined its acceptability to participants. Oxcarbazepine may cause more side effects than placebo. No differences in side effects were found between oxcarbazepine and other active medications.

All the studies examined mania, hypomania, mixed episodes or rapid-cycling disorder. More studies of better methodological quality are needed if we are to be certain whether oxcarbazepine works or not when treating mania, mixed episodes, depression and rapid-cycling in bipolar disorder.;

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Rated For Epilepsy Report

My teenage son started his first dose of Trileptal and got a severe headache about a hr after taking 1 pill. He went to bed and the next morning he was in convultions and called 911 and this started 9 months of blackout episodes. He only took 2 doses of this medicine and this created a lot of issues for him that took 9 months to go away. Only to find out that he was misdiagnosed and never had a seizure disorder but before the misdiagnoses he was on 3 other meds and all causes blackout episodes that were similar to seizures. He hasn’t had any more problems since being off all meds but were desperately trying to figure out what caused him to have blackout episodes and convolutions from Trileptal.

What Is The Most Important Information I Should Know About Trileptal

You should not take this medicine if you are allergic to oxcarbazepine or eslicarbazepine.

Tell your doctor if you have ever had:

• liver disease;
• mood problems or suicidal thoughts; or
• an allergy to carbamazepine .

Some people have thoughts about suicide while taking oxcarbazepine. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Do not start or stop taking oxcarbazepine during pregnancy without your doctor’s advice. Having a seizure during pregnancy could harm both mother and baby. Tell your doctor right away if you become pregnant while taking oxcarbazepine for seizures.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of oxcarbazepine on the baby.

Oxcarbazepine can make birth control pills less effective. Ask your doctor about using a non-hormonal birth control to prevent pregnancy.

You should not breast-feed while you are taking oxcarbazepine.

Do not give this medicine to a child without medical advice. There are specific age restrictions for the use of oxcarbazepine in children, depending on the dose form and whether it is used alone or with other medicines.

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When Its Time For A Transition

âIf you suspect your medication isnât managing your bipolar disorder the way it used to, or you just donât feel good, see your doctor right away,â says Michael F. Grunebaum, MD, a research psychiatrist at New York State Psychiatric Institute in New York City.

Important: If you suspect somethingâs really wrong — for example, youâre hearing voices, you want to hurt yourself, or youâre having severe pain in your midsection — go to an emergency room right away.

Your psychiatrist will talk with you and may recommend certain tests, such as blood tests, to figure out how your medications are affecting you.

Chances are, you wonât go off your medication right away.

âResearch shows that the safest way to stop is gradually over the course of several weeks, or even months,â Grunebaum says. âAbruptly stopping bipolar medication can cause a mood episode.â

What if you do have to stop taking medication ASAP — because itâs causing kidney or liver problems, for example? âThere are medications that can be used in the short term to control symptoms while you wait for the longer-term medication to begin working,â Schabbing says.

Concerned About Bipolar Disorder

Take our 2-minute Bipolar quiz to see if you or a loved one may benefit from further diagnosis and treatment.

Can children take Trileptal?Children are prescribed Trileptal for seizures, but the effectiveness and safety of use for bipolar disorder has not been established. Talk to your childs doctor about the risks and benefits and potential side effects to monitor.

Are there potential interaction issues for people taking Trileptal and any other drugs?There are hundreds of drugs which are known to interact with Trileptal in major, moderate, or mild ways, so let your doctor know what other medications you are taking before you begin taking the medication. Some of these might include amiodarone, amitriptyline, calcium channel blockers, chlorpromazine, clomipramine, cyclophosphamide, desmopressin, diazepam, diuretics, hormonal contraceptives, indapamide, seizure medications, proton-pump inhibitors, theophylline, and selective serotonin reuptake inhibitors. The medication can also decrease the effectiveness of hormonal contraceptives.

Are there any other medical conditions that would make someone ineligible for Trileptal therapy?Talk to your doctor about other medical conditions before you take Trileptal, such as kidney or liver disease.

What is the typical dose that would be prescribed to someone taking Trileptal?Dosage will vary depending on the age of the patient and the condition being treated.

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Warning Disclaimer Use For Publication

WARNING: Please DO NOT STOP MEDICATIONS without first consulting a physician since doing so could be hazardous to your health.

DISCLAIMER: All material available on eHealthMe.com is for informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare provider. All information is observation-only. Our phase IV clinical studies alone cannot establish cause-effect relationship. Different individuals may respond to medication in different ways. Every effort has been made to ensure that all information is accurate, up-to-date, and complete, but no guarantee is made to that effect. The use of the eHealthMe site and its content is at your own risk.

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