Research, dosage and side effects

Trileptal may be an effective treatment for bipolar disorder, but more research is needed to support its benefits.

Trileptal (brand name of the generic drug oxcarbazepine) is an anticonvulsant that doctors regularly prescribe as a second-line option to control seizures in adults and children.

Some research suggests that Tripeltal may also help treat symptoms of bipolar disorder, and it is sometimes used off-label for this purpose. However, more studies are needed before experts know its true benefits and risks when used in this way.

Bipolar disorder involves episodes of mania, depression, or both. Treatment plans often include talk therapy as well as medication, which may include a mood stabilizer, anticonvulsant, or antipsychotic.

Healthcare professionals may prescribe Trileptal for the following conditions:

  • seizures in adults and children
  • trigeminal neuralgia (severe facial pain) in multiple sclerosis
  • maintenance treatment for bipolar disorder

However, the Food and Drug Administration (FDA) has not approved Trileptal for bipolar disorder or trigeminal neuralgia because research is generally lacking for both conditions. It has only been approved by the FDA for use in seizure disorders in adults and children.

Trileptal has a similar action to carbamazepine, which is the drug from which it is derived. Carbamazepine has been studied more than Trileptal as a potential treatment for bipolar disorder. Accordingly, carbamazepine has already been approved by the FDA for hypomania, mild to moderate mania, and bipolar disorder with mixed features.

Recent research on the effectiveness of Trileptal for bipolar disorder is very limited. Most of the research on Trileptal and carbamazepine for bipolar disorder was done in the 1980s and 1990s.

However, a study 2022 examined the use of oxcarbazepine in people with bipolar disorder who were hospitalized during episodes of mania. They received between 900 mg and 2400 mg of oxcarbazepine daily, or they received sodium valproate. Researchers reported similar improvements in manic symptoms over a 6-week period for both drugs.

Additionally, the findings of a Literature Review 2021 reported the following potential benefits of oxcarbazepine for bipolar disorder:

  • may be effective for mild to moderate mania
  • may have mild to moderate efficacy for depressive episodes
  • may be useful as a complementary therapy
  • can be especially useful for hostile behavior

The researchers noted that in addition to more studies, higher quality studies are needed to confirm these potential benefits.

First-line treatments for bipolar disorder typically include antipsychotics or mood stabilizers, which alter certain mood-related brain chemicals, such as dopamine. Anticonvulsant drugs like Trileptal are used less frequently, but may also be considered.

Valproate is a well-known anticonvulsant that doctors most often give to people with mania in bipolar disorder.

Similar to Valproate, Trileptal works by lowering the amount of sodium in your brain. Sodium plays a vital role in the nervous system, helping nerve impulses travel throughout the body.

By altering sodium levels, Trileptal is thought to slow the rate of nerve impulses between neurons in the brain. This helps explain its effectiveness for seizures, where nerve impulses are overactive.

But like Valproate, researchers aren’t sure exactly why Trileptal is potentially effective for bipolar disorder.

Since Trileptal is not FDA approved for use in bipolar disorder, there are no standard dosage recommendations.

According to the National Alliance on Mental Illness, the typical dose range for oxcarbazepine is 900 to 1200 mg. People will usually start with a low dose and then slowly increase the dose over a few weeks. If you are taking this medicine for seizures, you can take up to 2400 mg per day.

The most common side effects of Trileptal or oxcarbazepine are:

  • dizziness
  • confusion
  • fatigue
  • eruption
  • visual changes
  • nausea or vomiting
  • headache
  • uncoordinated body movements

More serious side effects may also include:

Low sodium is a symptom of particular concern. This can lead to serious complications such as seizures. If you want to try Trileptal, your doctor will check your sodium levels regularly, especially during the first 3 months of use.

Also, if you want to stop using Trileptal, it is important to speak with your provider first. Suddenly stopping this medicine is dangerous.

Although it is sometimes used off-label for bipolar disorder, it seems that Trileptal has a long way to go before it gets FDA approval.

If you are living with bipolar disorder and looking for treatment options, you can talk to a medical professional about all of your choices.

To learn more about bipolar disorder and for additional help, you can:

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