Carbamazepine molecule is a derivative of dibenzoazepine. The substance has anti-epileptic activity, there is a neurotropic effect. The molecule is capable of producing a psychotropic effect. Carbamazepine acts stably on neuronal membranes, which are in a state of over-excitation, suppresses a series of neutron discharges, reduces the intensity of transmission of excitation pulses in synapses.
The drug blocks sodium channels, which way stops the appearance of potentials associated with sodium ions in neurons after depolarization. Tegretol eliminates anxiety and signs of depression, reduces irritability, relieves aggression in epilepsy (due to psychotropic effects). With idiopathic neuralgia, neuralgia of the secondary nature of the trigeminal nerve, the prevention of paroxysmal pain attacks is observed against the background of taking the drug. With abstinence, associated with alcohol, there is an increase in the threshold of convulsive readiness, as well as increased excitability, eliminated changes in gait, tremor.
With insulin-dependent diabetes, diuresis decreases, thirst decreases. In affective disorders, the drug is used as a psychotropic drug. It allows to conduct therapy of manic conditions of an acute nature, acts as an effective agent in supporting therapy of manic-depressive disorders (including as a mono-drug), in attacks of psychosis (schizoaffective). In combination with neuroleptics Tegretol helps with manic attacks, with a manic-depressive psychosis with fast-paced cycles. Manic symptoms relieve the drug due to the depressing effect on the exchange of neurotransmitters (HA, dopamine).
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Indications for use.
Tegretol is prescribed for:
Epilepsy (not effective drug for small and monoclonal attacks);
Manic states of an acute nature;
The need for maintenance therapy in bipolar affective disorders to prevent the development of exacerbations, reduce the symptoms of exacerbations;
Alcohol withdrawal syndrome;
Trigeminal neuralgia of idiopathic nature;
Neuralgia of the trigeminal nerve associated with multiple sclerosis;
Idiopathic neuralgia of the glossopharyngeal area;
Neuropathy on the background of diabetes with pain syndrome;
Insulin-dependent diabetes, associated with cerebral disorders, with polyuria and polydipsia associated with neurohormonal shifts.
Mode of application.
Tablets and syrup are intended for oral administration. Tablets should be taken with the use of liquid in small amounts. You can use Tegretol as a monotherapy. Before using Tegretol in liquid form (syrup), close the vial tightly and shake it. This is necessary for the uniform distribution of the drug throughout the syrup.
The drug in the form of a syrup is recommended for those who have difficulty with swallowing tablets, as well as those patients who need to individually dose the drug. Syrup therapy is started with low dosages, as there is a significant increase in the concentration of the active component in the blood compared to tablets. If you start treatment with a syrup from standard doses, then the development of side symptoms may occur. The dose can be divided not into two doses, but into three doses (to reduce the single dose).
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If you need to switch from Tegretol tablets to Tegretol tablets, you should consider that you may need to increase the dosage. If there is such a possibility, then it is necessary to prescribe Tegretol as a monotherapy. With small seizures, as well as with myoclonic seizures, the drug did not show sufficient efficacy.
Therapy should be started with the use of a minimally effective dosage. In the future, a slow increase in doses is carried out. When selecting optimal doses, it is recommended that tests be performed to determine the plasma concentrations of carbamazepine. Gradual increase in doses is necessary when using Tegretol in combination with anti-epileptic drugs. Initiate therapy in adult patients with 0.1-0.2 g of the drug. The dose is taken 1-2 times / day. In the future, the dose should rise to the one that will achieve the optimal therapeutic effect. The standard therapeutic dose is 0.8-1.2 g of carbamazepine (with a dose sharing of 2-3 doses). The daily dosage, if necessary, can be increased to 1.6-2 g of carbamazepine.
For pediatric patients up to 4 years of therapy should start with 0.02-0.06 mg / day. The dose is titrated upward by 0.02-0.06 mg / once every two days. Patients over 4 years of age are prescribed 0.1 g / day at the start of treatment. Titration of the dose upwards is 0.1 g / week. For patients younger than 36 months, a syrup is prescribed. Supportive therapy in pediatric patients are the standard dosage – 0.01-0.02 g / kg / day. The dosage is divided into several doses. Therapeutic dose for patients 4-5 years – 0.2-0.4 g; for patients 6-10 years old – 0.4-0.6 g; for patients 11-15 years old – 0.6-1 g.
Trigeminal neuralgia therapy begins with carbamazepine 0.2-0.4 g / day. The dosage is increased until the disappearance of pain syndrome (about 0.6-0.8 g). Subsequently, the dosage is reduced to the minimum effective, allowing to stop painful sensations. For gerontological patients, treatment starts with 0.2 g / day with a dose split into two doses.