Oxcarbazepine is an
antiepileptic drug that has been approved by the US FDA and is indicated for use as monotherapy or adjunctive
therapy in the treatment of
partial seizures in adults and children aged over 4 years. The aim of this report is to investigate the results of clinical trials in order to ascertain the efficacy and safety of
oxcarbazepine for use in
bipolar disorder and
schizoaffective disorder.
Oxcarbazepine is a keto-congener of
carbamazepine with fewer side effects and drug interactions. Orally administrated
oxcarbazepine is rapidly and completely absorbed and has a half-life of 9 h. Currently, there is a lack of controlled clinical trials studying the use of
oxcarbazepine. In light of controlled and open-label prospective studies, it may be useful for manic symptoms in the treatment of bipolar and schizoaffective patients. Case reports, retrospective and prospective studies suggest that
oxcarbazepine might have prophylactic efficacy and long-term benefit for these patients. In addition, owing to its lower propensity for drug interactions and side effects, it may be useful in the treatment of refractory patients with bipolar and
schizoaffective disorder. However, most of the trials have relevant methodological shortcomings. The side-effect profile of
oxcarbazepine is similar to
carbamazepine, but the severity of these effects appears to be slightly less. The symptoms that are most frequently associated with the use of
oxcarbazepine are
asthenia,
headache,
dizziness,
somnolence,
nausea,
diplopia and
skin rash. Isolated cases of hyponatremic
coma have been reported, thus
electrolyte abnormalities should be closely monitored.
Oxcarbazepine is now a
generic drug, but the metabolite
licarbazepine and other related compounds, such as
eslicarbazepine, are currently being studied under controlled conditions and might become useful
therapies for bipolar and
schizoaffective disorder in the future.