Oxcarbazepine: Primary or Combination Treatment for Epilepsy, Mood Disorders and Neuropathic Pain

Course overview

Oxcarbazepine is an anticonvulsant that has a labeled use as a monotherapy or adjunctive treatment for patients who suffer from focal seizures. Oxcarbazepine has also been used off-label to treat trigeminal neuralgia and other types of neuropathic pain, as well as mania associated with bipolar disorder. As an analog of carbamazepine, oxcarbazepine rapidly and almost completely converts to enantiomers with equal biologic activity and retains the efficacy of carbamazepine. Oxcarbazepine has been reported to have more favorable metabolic and pharmacokinetic tolerability, and a better safety profile than carbamazepine. However, at higher doses there can be poor tolerability of oxcarbazepine, specifically in the immediate- release form. The following sections discuss the basic pharmacological profile of oxcarbazepine, common uses, complications, and a brief overview of oxcarbazepine overdose. A clinical case study is also presented with a focus on differential diagnosis of focal seizure activity and treatment.