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Trileptal (Janet)

Q: Today I was diagnosed as bipolar type II, and given a prescription for Trileptal (300mg) tablets. Before taking the first one , I 
looked for information on this drug and eventually found your site. Thank you for posting the information. It helped me to believe 
that this doctor is on the right track with helping me. I tried to access the board and the link did not work. As you cannot answer 
email, I am hoping to find a board or discussion group where this drug is used for treatment. I am hoping that in the near future 
you will include information concerning the treatment with Trileptal. And I am hoping that for myself and others that the effects 
are positive.

Dear Janet
Thanks for the note and the "heads up" about the link: fixed it. About Trileptal: I'm surprised to hear it, as you're the first person 
I've encountered using it, but that's only because the medication is a close cousin of a very commonly used medication 
(carbamazepine -- yours is oxcarbazepine; trade names for carbamazepine are Tegretol and Carbatrol). 

So in one respect there is information on my site about your medication, if one assumes that oxcarbazepine (your Trileptal) is 
equivalent to carbamazepine for the treatment of bipolar disorder. There are no data to say yes or no about this yet, to my 
knowledge. The Trileptal people developed this medication as an alternative to carbamazepine to get away from two major 
problems carbamazepine has. First, it "induces liver enzymes"; translation -- it causes the liver to increase the number of enzymes 
that break down most common medications. As a result, carbamazepine causes decreases in blood levels of many medications 
(not all). That can mess up a good thing. The classic example is birth control pills -- they can "stop working" when 
carbamazepine is added. 

The second big problem carbamazepine has is that it can cause blood cell production problems. This can be a major problem, and 
if undetected, it can even be fatal. On the other hand, if properly monitored, the risk of this problem can be kept quite low. 
However, it's a bigger risk than other alternatives like Depakote and lithium have. 

So, you can see why a carbamazepine that might not have these problems (it is too early to say for sure) would be an attractive 
addition to our medication menu. If it works for you, great. If not, there are alternatives, as you have seen. 

Dr. Phelps

Published October, 2000

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