Oxcarbazepine: clinical experience with hospitalized psychiatric patients.
BACKGROUND
Oxcarbazepine (10-keto-carbamazepine) appears to be better tolerated and simpler to use than carbamazepine. It has antimanic effects but, as its potential clinical usefulness and tolerability in broad samples of psychiatric patients remain to be tested, we reviewed both the pharmacology of oxcarbazepine and our early experience with this new agent among psychiatric inpatients.


METHODS
We reviewed medical records of all inpatients given oxcarbazepine in the first 15 months of its use at McLean Hospital. Data analyzed included dosing, presenting illnesses, other medications, clinical changes, and adverse effects.


RESULTS
Oxcarbazepine was given to 56 inpatients (1.3% of admissions; 31 women, 25 men) presenting with depression (n = 23), mania (n = 19), or psychosis (n = 14). The discharge daily dose for the 43 patients (76%) taking oxcarbazepine was 831 mg/day, 34% higher in men than women, and fell by 9 mg/year-of-age. Oxcarbazepine was the only putative mood-stabilizing agent given at discharge in 19 of 43 cases (44%). It was discontinued in 20% of patients for apparent inefficacy, and 4% for adverse effects. Changes in CGI and GAF scores were similarly high across illnesses, and unrelated to days of use of oxcarbazepine or its dose.


CONCLUSIONS
Oxcarbazepine was well tolerated and simpler to use clinically than its precursor carbamazepine. This agent should be studied in controlled trials to test its efficacy in specific types of major psychiatric disorders, and particularly for long-term maintenance treatment in bipolar disorder.
Centorrino
Franca
F
Consolidated Department of Psychiatry, Harvard Medical School, Boston, MA, USA. centorf@mcleanpo.mclean.org
Albert
Matthew J
MJ
Berry
Judith M
JM
Kelleher
James P
JP
Fellman
Veronica
V
Line
Gyorgy
G
Koukopoulos
Alexia E
AE
Kidwell
Jennifer E
JE
Fogarty
Kate V
KV
Baldessarini
Ross J
RJ
D000367:Age Factors; D000927:Anticonvulsants / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy*; D002220:Carbamazepine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007297:Inpatients; D008297:Male; D000078330:Oxcarbazepine; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000927:Anticonvulsants; D002220:Carbamazepine; D000078330:Oxcarbazepine