Guidelines
Weaknesses: Strong pharmacokinetic interaction with many other medications - Carbamazepine has antimanic efficacy but is rarely advocated for first line treatment. Carbamazepine is not the optimal partner for combination therapy because its liver-enzyme inducing properties may reduce the levels of other drugs, which in turn, may inhibit the catabolism of carbamazepine. [BAP Guidelines]
Risk of agranulocytosis (clinical vigilance and periodic blood counts are prudent) - Up to 50% of patients receiving carbamazepine experience side effects and the drug is associated with potentially serious adverse reactions. [APA Guidelines]
Risk of skin rash (similar to lamotrigine) Up to 50% of patients receiving carbamazepine experience side effects and the drug is associated with potentially serious adverse reactions. [APA Guidelines]GSK counterclaim: Less effective in treating depression compared with mania - While unlikely to provoke a manic switch, lithium, valproate, and carbamazepine have inadequate evidence for acute antidepressant efficacy. [BAP Guidelines]
American Psychiatric Association American Psychiatric Association British Association for Psychopharmacology British Association for Psychopharmacology British Association for Psychopharmacology British Association for Psychopharmacology
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