Overview
Tegretol is a common brand name for Carbamazepine. Tegretol is an anticonvulsant and antimanic drug. Tegretol can be used alone, or it may be used with lithium or a neuroleptic (a type of drug that reduces confusion and agitation) when used to treat certain manic conditions.

Tegretol’s effects can be felt about two hours after it is taken, though it may require three months of more of therapy to determine if it reduces the amount and severity of seizures. When used to relieve nerve pain, effects are usually felt in 24 to 48 hours.

Why is this drug prescribed?
Tegretol is used to treat seizures due to epilepsy. It is also used to treat

1. trigeminal neuralgia (a type of nerve pain such as tic douloureux.)
2. pain associated with shingles
3. acute mania
4. frequent episodes of mania (rapid cycles)
5. dysphoric mania
6. preventative treatment for bipolar disorder (manic depression)
7. alcohol withdrawal
8. cocaine withdrawal
9. abnormally aggressive behavior
10. migraine headaches

Warnings and Precautions
Tegretol is generally not recommended for children under six years old. However, it has been used in children under six to treat epileptic seizures.

Tegretol is not addictive. Suddenly discontinuing this drug can cause withdrawal symptoms such as mania or depression. Dosage should be gradually tapered.

Tegretol can cause dizziness and sleepiness. Patients should not drive or operate heavy machinery until they are certain that Tegretol does not affect the ability to safely engage in these activities.

Tegretol reduces the effectiveness of oral contraceptives. A non-hormonal method of birth control should be used instead.

Tegretol can cause photosensitivity and can reduce sweating which impairs the body's ability to adapt to heat. Patients should avoid saunas and other very hot environments.

When taken for epilepsy, Tegretol should not be discontinued suddenly; doing so could cause continuous epileptic attacks without return to consciousness, leading to possible severe brain damage and death.

For Pregnant or Nursing Mothers: There exists a small chance that Tegretol, like all major antiepileptic drugs, increases the risk of malformation, and rare cases have been reported. Conclusive results have not yet been found. Tegretol passes into breast milk, and may cause sleepiness in the nursing infant.

Contraindications
Tegretol should Not be used for people with the following medical conditions:

1. hypersensitivity or allergy to Tegretol or a heterocyclic antidepressant
2. liver disease
3. serious blood disorder
4. AV heart block
5. acute intermittent porphyria
6. a history of bone marrow depression

Adverse Reactions
Tegretol may cause the following reactions:

1. dizziness
2. drowsiness
3. high fever
4. blurred vision
5. clumsiness / unsteadiness
6. pigmentation in eyes
7. infection
8. weakness
9. abnormal bleeding
10. constipation
11. indigestion
12. dry mouth and throat
13. skin changes
14. yellowing of skin / eyes
15. impaired urination
16. decreased sense of taste
17. loss of appetite
18. poor coordination
19. mental changes
20. nausea / vomiting
21. aching joints
22. diarrhea
23. low white blood cell count
24. fatigue
25. confusion
26. male infertility
27. photosensitivity
28. agranulocytosis (a serious or even fatal deficiency of certain blood cells)
29. aplastic anemia (low red and white blood cell production)
30. liver irritation
31. vitamin D deficiency
32. low thyroid hormones

Interactions with Drugs and Other Substances
Drugs or substances that may interact with Tegretol are:

1. MAO Inhibitors (within 14 days) – serious, even fatal interactions can occur when taken with Tegretol
2. alcohol – when taken with Tegretol can dangerously lower blood pressure
3. Seldane (terfenadine), Prozac (fluoxetine), Luvox (fluvoxamine), and rifampin - can lead to drug toxicity
4. tranquilizers, hypnotics, and narcotics – Tegretol can increase the effects of these drugs
5. adrenocortical steroids, antidepressants, birth control pills, Sandimmune (cyclosporine), Doxy-II and Vibramycin (doxycycline), Plendil (felodipine), Haldol (haloperidol), DynaCirc (isradipine), Sporanox (itraconazole), tetracyclines, Depakene (valproic acid), and Coumadin (warfarin) – Tegretol can decrease the effects of these drugs
6. Clozaril (clozapine) – can cause serious bone marrow suppression when taken with Tegretol
7. Felbatol (felbamate) – can reduce the body’s levels of Tegretol
8. Lithium - taken with Tegretol can cause neurological problems such as confusion, tremors, and weakness
9. Dilanin (phenytoin) – can impair seizure control due to fluctuation of blood levels
10. Theo-Dur (theophylline) - when taken with Tegretol, the effects of both of these drugs can decrease
11. Tagamet (cimetidine), Danocrine (danazol), Cardizem (diltiazem), flu shots, INH (isoniazid), erythromycin and other macrolide antibiotics, nicotinamide, Darvon (propoxyphene), Norvir (ritonavir), and Calan / Isoptin (verapamil) – these drugs may increase the effects of Tegretol
12. Phenobarbital and Biaxin (clarithromycin) - can increase the toxicity of Tegretol

http://www.mentalhealth.com/drug/

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http://www.psyweb.com/Drughtm/carbam.html

http://www.healthsquare.com/newrx/TEG1430.htm

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