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Psychiatrienet β


Type moodstabilizer
Group anticonvulsant
ATC-code N03AF01
Medscape Carbamazepine
PubChem 2554
PubMed Carbamazepine carbamazepine
Kompas (Dutch) Carbamazepine
Wikipedia Carbamazepine
Type moodstabilizer
Group other
ATC-code N05AN01
Medscape Lithium
PubChem 11125
PubMed Lithium lithium
Kompas (Dutch) Lithium
Wikipedia Lithium

Adding lithium to carbamazepine.

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General information
  • Carbamazepine is principally metabolized by CYP3A4, and is a potent inducer of CYP1A2, CYP2C9, CYP3A4 and UDP-glucuronosyltransferases.
  • Lithium is eliminated by the kidney for about 95%. Changes in the rate of excretion can cause unwanted effects.
  • The available data suggest that the combination of lithium and carbamazepine is safe and effective, especially for rapid-cycling patients.[5]
  • Lithium and carbamazepine may work synergistically.[5]
  • Patients receiving both lithium and carbamazepine experience better prophylaxis against bipolar episodes than patients treated with either medication alone.[5]
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Start lithium
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  • The combination may rarely cause neurotoxicity without increased plasma levels. [6]
  • The combination of these two drugs is generally safe and effective, but it should be avoided for patients with comorbid CNS (central nervous system) disease. Cases of neurotoxicity and asterixis have been reported with the concomitant use of lithium and carbamazepine.[5]

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