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Recommendations on the clinical use of oxcarbazepine in the treatment of epilepsy: a consensus view.Acta Neurologica Scandinavica Sep 2001Extensive clinical use and a series of clinical trials have shown that oxcarbazepine is a valuable antiepileptic drug for the treatment of adults and children with... (Review)
Review
Extensive clinical use and a series of clinical trials have shown that oxcarbazepine is a valuable antiepileptic drug for the treatment of adults and children with partial onset seizures both in initial monotherapy, for conversion to monotherapy and as adjunctive therapy. The clinically recommended titration scheme for all forms of therapy in adults is to start with 150 mg/day at night and to increase by 150 mg/day every second day until a target dose of 900-1200 mg/day is reached. If necessary, one can go faster and start with up to 600 mg/day and titrate with weekly increments of up to 600 mg/day. In children, treatment can be initiated with 8-10 mg/kg/day body weight in two to three divided doses. Dosage can be increased by 8-10 mg/kg/day in weekly increments if necessary for seizure control. Hyponatremia (serum sodium <125 mmol/l) can develop gradually during the first months of oxcarbazepine therapy in approximately 3% of patients with a previously normal serum sodium. However, there is no need to measure baseline serum sodium concentrations unless the patient has renal disease, is taking medication which may lower serum sodium levels (such as diuretics, oral contraceptives or nonsteroidal anti-inflammatory drugs) or--in rare cases--has clinical symptoms of hyponatremia. During oxcarbazepine maintenance therapy measurement of serum sodium levels should also be considered if medications known to decrease sodium levels are added or symptoms of hyponatremia develop. Oxcarbazepine does not appear to have any clinically notable effects on other safety parameters such as renal and liver function or haematological test results. In summary, oxcarbazepine is a safe and well tolerated antiepileptic drug for partial epilepsy.
Topics: Anticonvulsants; Carbamazepine; Clinical Trials as Topic; Epilepsies, Partial; Humans; Oxcarbazepine; Treatment Outcome
PubMed: 11551237
DOI: 10.1034/j.1600-0404.2001.00870.x -
Clinical and Diagnostic Laboratory... Apr 2005
Topics: Anticonvulsants; B-Lymphocytes; Carbamazepine; Female; Humans; Immunoglobulins; Middle Aged; Oxcarbazepine; Pain; Time Factors
PubMed: 15817769
DOI: 10.1128/CDLI.12.4.560-561.2005 -
Clinical Neuropharmacology 2010There is no pharmacological treatment of trichotillomania that has consistently demonstrated efficacy, although good results have been obtained with antidepressants and...
OBJECTIVE
There is no pharmacological treatment of trichotillomania that has consistently demonstrated efficacy, although good results have been obtained with antidepressants and other drugs such as atypical antipsychotics, bupropion, lithium, and topiramate. The anticonvulsant oxcarbazepine has also been used as mood stabilizer and has been tested for treating binge eating, but there is no report on oxcarbazepine in trichotillomania.
CASE
We report the case of an obese 43-year-old woman with a diagnosis of trichotillomania in comorbidity with binge eating disorder who was treated with a flexible dose of the anticonvulsant oxcarbazepine.
RESULT
We administered oxcarbazepine at a dosage of 1200 mg/d, and this subject improved both in hair pulling and in eating behaviors with no relapse after 9 months.
CONCLUSIONS
Further studies with a wide sample of patients are needed to prove the efficacy of oxcarbazepine and the long-term maintenance of these benefits. Relationships of trichotillomania with bipolar spectrum should also be investigated.
Topics: Adult; Anticonvulsants; Binge-Eating Disorder; Carbamazepine; Female; Humans; Oxcarbazepine; Trichotillomania
PubMed: 20375658
DOI: 10.1097/WNF.0b013e3181c8764f -
Psychiatry Research Oct 2021Patients receiving mood stabilizers such as valproate (VAL) and carbamazepine (CMZP)/Oxcarbazepine (OX) may be referred for electroconvulsive therapy (ECT). The relative...
Patients receiving mood stabilizers such as valproate (VAL) and carbamazepine (CMZP)/Oxcarbazepine (OX) may be referred for electroconvulsive therapy (ECT). The relative effects of these anticonvulsants on seizure threshold and seizure duration are unknown. We extracted data for a 20-month period from the medical records of patients who received bilateral ECT while on treatment with VAL (n=102) or CMZP/OX (n=31; 20 on CMZP, 11 on oxcarbazepine). Age-matched ECT-treated anticonvulsant-free patients (n=133) formed the control group. Seizure threshold in these patients had been determined by stimulus dose titration. The effect of VAL vs CMZP/OX on seizure threshold was examined using multivariable regression with adjustment for confounders. The mean (standard deviation) seizure threshold at the first ECT was highest in the CMZP/OX group (243.9 [106.1] mC), intermediate in the VAL group (177.7 [97.0] mC), and lowest in the control group (138.7 [86.0 Mc]). The regression model explained 37.5% of the variance in seizure threshold at the first ECT. Age, use of CMZP/OX, and anticonvulsant dose were each significantly associated with higher seizure threshold. CMZP/OX was associated with a higher initial ECT seizure threshold than VAL. ECT practitioners may prefer to start with a higher initial stimulus dose in patients receiving CMZP/OX or VAL, and more so for CMZP/OX than VAL, to avoid repeated sub-convulsive stimuli being administered.
Topics: Carbamazepine; Electroconvulsive Therapy; Humans; Oxcarbazepine; Seizures; Valproic Acid
PubMed: 34384943
DOI: 10.1016/j.psychres.2021.114149 -
Revista de NeurologiaAntiepileptic drugs (AED) have long been known to have a series of side effects and descriptions of drug hypersensitivity syndrome (DHS) have often linked it with these... (Review)
Review
INTRODUCTION
Antiepileptic drugs (AED) have long been known to have a series of side effects and descriptions of drug hypersensitivity syndrome (DHS) have often linked it with these agents. This is more especially so in the case of those with an aromatic ring, but also in those that lack such a structure.
CASE REPORT
We describe a case of DHS related to the administration of oxcarbazepine (OXC), a ketoanalogue of carbamazepine (CBZ) that has recently appeared on the market in our country, which coursed with interstitial nephritis as the most important clinical manifestation. Our patient developed fever, vomiting, itchy exanthema, kidney failure and biochemical anomalies in the liver after two weeks treatment with this drug. After stopping administration of this anticonvulsant and giving the patient corticoids, the clinical manifestations disappeared and the analytical anomalies began to improve.
CONCLUSIONS
OXC can give rise to DHS in the same way as other AED with an aromatic ring structure (phenytoin, phenobarbital, primidone, CBZ and probably also lamotrigine) or without an aromatic ring structure (valproic). Interstitial nephritis may be the most significant and serious clinical manifestation of DHS produced by OXC. According to the review of the literature we carried out, to date no descriptions of this association of nephritis caused by OXC in the context of DHS have been reported.
Topics: Anticonvulsants; Carbamazepine; Drug Hypersensitivity; Female; Humans; Middle Aged; Nephritis, Interstitial; Oxcarbazepine; Syndrome
PubMed: 14634926
DOI: No ID Found -
The Journal of Clinical Psychiatry Aug 2003To assess the effectiveness and safety of oxcarbazepine in bipolar disorder. (Comparative Study)
Comparative Study
OBJECTIVE
To assess the effectiveness and safety of oxcarbazepine in bipolar disorder.
METHOD
A chart review of naturalistic treatment with oxcarbazepine in 42 outpatients with DSM-IV bipolar disorder (10 males, 32 females; mean +/- SD age = 33.3 +/- 12.4 years; 25 with bipolar disorder type I, 4 with bipolar disorder type II, and 13 with bipolar disorder not otherwise specified) was conducted. Patients had received oxcarbazepine monotherapy or adjunctive therapy between April 2000 and April 2002. Treatment response was defined as a Clinical Global Impressions-Improvement scale score of 1 (marked improvement) or 2 (moderate improvement).
RESULTS
Oxcarbazepine was moderately to markedly effective in 24 subjects (57%). Mixed symptoms were the most common indication (52% [22/42]). The mean oxcarbazepine dose was 1056.6 mg/day, and mean treatment duration was 16.2 weeks. Sedation (17/42, 40%) was the most common side effect, but 16 patients (38%) had no side effects. Twenty-two patients (52%) stopped treatment, mostly due to side effects (12/22). Males were more likely to respond than females (10/10 vs. 14/32, p =.006). Dose, bipolar subtype, indication, past nonresponse to mood stabilizers, concurrent mood stabilizer use, and monotherapy use of oxcarbazepine did not differentially predict response.
CONCLUSION
Oxcarbazepine appeared effective in about one half of patients with bipolar disorder and was well tolerated.
Topics: Adolescent; Adult; Ambulatory Care; Anticonvulsants; Bipolar Disorder; Carbamazepine; Drug Administration Schedule; Drug Therapy, Combination; Female; Humans; Lithium; Male; Medical Records; Middle Aged; Oxcarbazepine; Patient Dropouts; Pilot Projects; Psychiatric Status Rating Scales; Sex Factors; Treatment Outcome
PubMed: 12927010
DOI: 10.4088/jcp.v64n0813 -
Nature Reviews. Disease Primers May 2024Trigeminal neuralgia (TN) is a facial pain disorder characterized by intense and paroxysmal pain that profoundly affects quality of life and presents complex challenges... (Review)
Review
Trigeminal neuralgia (TN) is a facial pain disorder characterized by intense and paroxysmal pain that profoundly affects quality of life and presents complex challenges in diagnosis and treatment. TN can be categorized as classical, secondary and idiopathic. Epidemiological studies show variable incidence rates and an increased prevalence in women and in the elderly, with familial cases suggesting genetic factors. The pathophysiology of TN is multifactorial and involves genetic predisposition, anatomical changes, and neurophysiological factors, leading to hyperexcitable neuronal states, central sensitization and widespread neural plasticity changes. Neurovascular compression of the trigeminal root, which undergoes major morphological changes, and focal demyelination of primary trigeminal afferents are key aetiological factors in TN. Structural and functional brain imaging studies in patients with TN demonstrated abnormalities in brain regions responsible for pain modulation and emotional processing of pain. Treatment of TN involves a multifaceted approach that considers patient-specific factors, including the type of TN, with initial pharmacotherapy followed by surgical options if necessary. First-line pharmacological treatments include carbamazepine and oxcarbazepine. Surgical interventions, including microvascular decompression and percutaneous neuroablative procedures, can be considered at an early stage if pharmacotherapy is not sufficient for pain control or has intolerable adverse effects or contraindications.
Topics: Trigeminal Neuralgia; Humans; Carbamazepine; Quality of Life; Oxcarbazepine; Female
PubMed: 38816415
DOI: 10.1038/s41572-024-00523-z -
Epilepsy Research Mar 2019To determine the clinical outcomes of brand-to- generic oxcarbazepine (OXC) switch in patients with epilepsy. (Observational Study)
Observational Study
PURPOSE
To determine the clinical outcomes of brand-to- generic oxcarbazepine (OXC) switch in patients with epilepsy.
METHODS
This prospective observational study included 103 patients treated with OXC in the tertiary outpatient epilepsy clinic. In 2016 the price of the brand-name OXC in Poland increased by 10 times in comparison to the generic products. Assuming that the majority of the patients would be forced to switch to generic drugs due to financial issues we decided to follow them prospectively to evaluate the safety of switching from brand-name to generic OXC.
RESULTS
A quarter of our cohort (26%) decided to continue on brand-name OXC, the majority (74%) switched to generic products. We did not find differences in terms of frequency of seizures and adverse events between patients continuing on brand-name OXC and those switching to generic AED.
CONCLUSION
The switching from brand-name to generic OXC seems to be safe, however, larger prospective studies are required in order to confirm our findings.
Topics: Adult; Anticonvulsants; Cohort Studies; Drug Substitution; Drugs, Generic; Epilepsy; Female; Humans; Male; Middle Aged; Outpatients; Oxcarbazepine; Statistics, Nonparametric
PubMed: 30836239
DOI: 10.1016/j.eplepsyres.2019.02.017 -
Epilepsy & Behavior : E&B Nov 2005Relatively few well-designed studies have demonstrated the long-term safety and tolerability of newer antiepileptic drugs (AEDs) in a large group of children. Extensive... (Review)
Review
Relatively few well-designed studies have demonstrated the long-term safety and tolerability of newer antiepileptic drugs (AEDs) in a large group of children. Extensive clinical data from the worldwide Clinical Development Program (CDP) and a compassionate use program on the safety and tolerability of oxcarbazepine in children are presented. Oxcarbazepine is a newer AED that is indicated for use as monotherapy and adjunctive therapy in children (United States 4 years of age, Europe 6 years of age) with partial epilepsy. The most common adverse events (10%) in the CDP were headache (32.5%), somnolence (31.5%), vomiting (27.6%), and dizziness (23.1%), whereas in the compassionate use program (clinical practice situation), the most common adverse events (1%) reported were rash (2.7%), fatigue (1.6%), nausea (1.2%), and somnolence (1.2%). These data indicate that oxcarbazepine has a good long-term safety and tolerability profile, whether given as monotherapy or adjunctive therapy, in children with partial seizures.
Topics: Adolescent; Anticonvulsants; Carbamazepine; Child; Clinical Trials as Topic; Databases, Factual; Double-Blind Method; Epilepsy; Humans; Oxcarbazepine; Randomized Controlled Trials as Topic
PubMed: 16176888
DOI: 10.1016/j.yebeh.2005.07.017 -
European Journal of Hospital Pharmacy :... Mar 2023Oxcarbazepine (OXC) is metabolised to active 10-monohydroxy derivative (MHD) after oral administration. Using this fact we aimed to develop an MHD population...
OBJECTIVE
Oxcarbazepine (OXC) is metabolised to active 10-monohydroxy derivative (MHD) after oral administration. Using this fact we aimed to develop an MHD population pharmacokinetic (PPK) model in Chinese adult epileptic patients to facilitate the clinical implementation of model-guided individualised drug therapy.
METHODS
We collected blood samples from Chinese adult epileptic patients taking OXC at the Second Affiliated Hospital of Zhejiang University School of Medicine. We used high performance liquid chromatography (HPLC-MS/MS) with tandem mass spectrometry to detect MHD concentrations in the blood samples. We collected various data from patients including their demographic, pathological, and physiological information. MassARRAY method was used to detect , , , , , , , and gene polymorphisms. We used a nonlinear mixed-effects modelling method to develop the PPK model and we predicted dosing regimens through simulation.
RESULT
In total we collected 164 blood samples from 118 patients. We found that a one-compartment model with first-order absorption better described the in vivo MHD pharmacokinetics. gene (rs7439366) site mutation and the combined use of valproic acid enhanced the MHD clearance rate. We divided patients into groups based on the genotype and whether they were also using valproic acid at the same time. Individualised OXC dosing regimens were proposed for different subgroups of patients.
CONCLUSION
In Chinese adult epileptic patients, individualised drug administration can be facilitated using a PPK model of OXC.
TRIAL REGISTRATION NUMBER
ChiCTR-OOC-17012141.
Topics: Humans; Adult; Oxcarbazepine; Anticonvulsants; Carbamazepine; Valproic Acid; East Asian People; Tandem Mass Spectrometry; Polymorphism, Single Nucleotide; Epilepsy
PubMed: 35787526
DOI: 10.1136/ejhpharm-2022-003357