Re: What would be a good anti convusant?:

Posted by ed_uk on October 29, 2004, at 6:17:40

In reply to What would be a good anti convusant?:, posted by Eljakeo25 on October 28, 2004, at 11:29:56

Hi it's Ed, here is some info on Trileptal...........
Oxcarbazepine(Trileptal)
Interactions with other drugs:
Information is taken from the British National Formulary(I am from the UK), I have added some comments of my own.
Antipsychotics: anticonvulsant effect of oxcarbazepine antagonised by antipsychotics (convulsive threshold lowered). (This is not relevant unless you are epileptic.) Increased risk of toxicity with myelosuppressive drugs (although Risperdal is not myelosupressive so don't worry!)

Carbamazepine: oxcarbazepine sometimes reduces plasma concentration of carbamazepine (but concentration of an active metabolite of carbamazepine may be increased), also plasma concentration of an active metabolite of oxcarbazepine often reduced. You won't ever be taking carbamazepine at the same time as Trileptal so don't worry about this either

MAOIs: manufacturer of oxcarbazepine advises avoid concomitant use with MAOIs. (I take it you're not on an MAOI since you are taking Cymbalta).
Oestrogens: oxcarbazepine accelerates metabolism of oestrogens (reduced contraceptive effect—see section 7.3.1) Interactions of combined oral contraceptives may also apply to combined contraceptive patches; in case of hormone replacement therapy low dose unlikely to induce interactions

Phenobarbital: oxcarbazepine increases plasma concentration of phenobarbital , also plasma concentration of an active metabolite of oxcarbazepine reduced.

Phenytoin: oxcarbazepine increases plasma concentration of phenytoin , also plasma concentration of an active metabolite of oxcarbazepine reduced
Primidone: oxcarbazepine increases plasma concentration of an active metabolite of primidone , also plasma concentration of an active metabolite of oxcarbazepine reduced.

Progestogens: oxcarbazepine accelerates metabolism of progestogens. Interactions of combined oral contraceptives may also apply to combined contraceptive patches

Valproate: plasma concentration of an active metabolite of oxcarbazepine sometimes reduced by valproate
Oxcarbazepine belongs to Antiepileptics and will have the following interactions:
Antidepressants:
anticonvulsant effect of antiepileptics antagonised by SSRIs (convulsive threshold lowered). (This is not relevant unless you are epileptic.)
Chloroquine and Hydroxychloroquine: possible increased risk of convulsions when antiepileptics given with chloroquine and hydroxychloroquine.
Mefloquine: anticonvulsant effect of antiepileptics antagonised by mefloquine.
In summary, I don't think that Trileptal will interfere with any of the medications you are on....... I don't remember everything you are taking so tell me if I'm wrong!! At least there is no mention of an interaction with stimulants.
Here is some more information from the BNF on Trileptal(OXCARBAZEPINE)
Indications/uses: monotherapy and adjunctive treatment of partial seizures with or without secondarily generalised tonic-clonic seizures
(As you can see it is only licensed/approved for the treatment of epilepsy)
Cautions ie. reasons to avoid Trileptal: hypersensitivity to carbamazepine; avoid abrupt withdrawal; hepatic impairment, renal impairment, pregnancy, breast-feeding, elderly, hyponatraemia (monitor plasma-sodium concentration in patients at risk), heart failure (monitor body-weight), cardiac conduction disorders; avoid in porphyria.
Trileptal can cause BLOOD, HEPATIC(Liver) OR SKIN DISORDERS. Patients or their carers should be told how to recognise signs of blood, liver, or skin disorders, and advised to seek immediate medical attention if symptoms such as lethargy, confusion, muscular twitching, fever, sore throat, rash, blistering, mouth ulcers, bruising, or bleeding develop.
RE: you were worried about taking anything which may effect your liver. Tegretol, Trileptal and valproate/divalproex/valproic acid all have the potential to cause liver disease occasionally. Some doctors may choose to monitor your liver function tests/liver panel while taking these medications.
Side-effects: nausea, vomiting, constipation, diarrhoea, abdominal pain, dizziness, headache, drowsiness, agitation, amnesia, asthenia, ataxia, confusion, impaired concentration, depression, tremor, hyponatraemia, acne, alopecia, rash, vertigo, nystagmus, visual disorders including diplopia; less commonly urticaria, leucopenia; rarely arrhythmias, Stevens-Johnson syndrome, systemic lupus erythematosus, hepatitis, thrombocytopenia, angioedema, hypersensitivity reactions.
I know you want to avoid any drugs that can cause sedation but sadly all anticonvulsants have the potential to cause drowsiness, especially Klonopin! Basically, you won't know whether it makes you drowsy unless you try it.
Dose: initially 300 mg twice daily increased according to response in steps of up to 600 mg daily at weekly intervals; usual dose range 0.6–2.4 g daily in divided doses; child over 6 years, 8–10 mg/kg daily in 2 divided doses increased according to response in steps of up to 10 mg/kg daily at weekly intervals (in adjunctive therapy, maintenance dose approx. 30 mg/kg daily); max. 46 mg/kg daily in divided doses
Note. In adjunctive therapy, patients may require dose reduction of concomitant antiepileptics when using high doses of oxcarbazepine.
I hope this info is useful and not too overwhelming. If you have any more questions about anticonvulsants just ask...
Ed

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What would be a good anti convusant?: Eljakeo25 10/28/04
Trileptal effects? Eljakeo25 10/28/04
Re: What would be a good anti convusant?: ed_uk 10/29/04

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