Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1989 Apr;52(4):472–476. doi: 10.1136/jnnp.52.4.472

Oxcarbazepine: a new drug in the management of intractable trigeminal neuralgia.

J M Zakrzewska 1, P N Patsalos 1
PMCID: PMC1032294  PMID: 2738589

Abstract

The efficacy and tolerability of oxcarbazepine, a keto derivative of carbamazepine, has been assessed in six patients (two males, four females; mean age 61 years, range 42-77), with trigeminal neuralgia refractory to carbamazepine therapy, over a period of 6 months. An excellent therapeutic response to oxcarbazepine was seen in all patients with pain control correlating well with serum drug concentrations of oxcarbazepine and its primary active metabolite 10-OH-carbazepine. Onset of the effect was observed within 24 hours in all cases. An overall serum therapeutic concentration range, in the six patients, of 50-110 mumol/l of 10-OH-carbazepine corresponding to a daily effective dose range of 1200-2400 mg (14.6-35.6 mg/kg body weight) oxcarbazepine, was observed. There was a significant correlation between oxcarbazepine dose and serum oxcarbazepine (r = 0.695, p less than 0.05) and 10-OH-carbazepine (r = 0.957, p less than 0.001) concentrations. Oxcarbazepine was well tolerated and no significant side effects were identified, though a mild hyponatraemia was observed during high doses (greater than 28 and greater than 35 mg/kg/day) in two patients. It is concluded that oxcarbazepine has potent antineuralgic properties in the absence of significant side effects and therefore may be useful in the management of intractable trigeminal neuralgia.

Full text

PDF
472

Images in this article

475Image
on p.475

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bittencourt P. R., Silvado C. E. Oxcarbazepine, GP 47779, and spasticity. Lancet. 1985 Sep 21;2(8456):676–676. doi: 10.1016/s0140-6736(85)90049-2. [DOI] [PubMed] [Google Scholar]
  2. Campbell F. G., Graham J. G., Zilkha K. J. Clinical trial of carbazepine (tegretol) in trigeminal neuralgia. J Neurol Neurosurg Psychiatry. 1966 Jun;29(3):265–267. doi: 10.1136/jnnp.29.3.265. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Emrich H. M., Dose M., von Zerssen D. The use of sodium valproate, carbamazepine and oxcarbazepine in patients with affective disorders. J Affect Disord. 1985 May-Jun;8(3):243–250. doi: 10.1016/0165-0327(85)90022-9. [DOI] [PubMed] [Google Scholar]
  4. Farago F. Trigeminal neuralgia: its treatment with two new carbamazepine analogues. Eur Neurol. 1987;26(2):73–83. doi: 10.1159/000116315. [DOI] [PubMed] [Google Scholar]
  5. Houtkooper M. A., Lammertsma A., Meyer J. W., Goedhart D. M., Meinardi H., van Oorschot C. A., Blom G. F., Höppener R. J., Hulsman J. A. Oxcarbazepine (GP 47.680): a possible alternative to carbamazepine? Epilepsia. 1987 Nov-Dec;28(6):693–698. doi: 10.1111/j.1528-1157.1987.tb03702.x. [DOI] [PubMed] [Google Scholar]
  6. Johannessen A. C., Nielsen O. A. Hyponatremia induced by oxcarbazepine. Epilepsy Res. 1987 Mar;1(2):155–156. doi: 10.1016/0920-1211(87)90025-8. [DOI] [PubMed] [Google Scholar]
  7. Rasmussen P., Riishede J. Facial pain treated with carbamazepin (Tegretol). Acta Neurol Scand. 1970;46(4):385–408. doi: 10.1111/j.1600-0404.1970.tb05803.x. [DOI] [PubMed] [Google Scholar]
  8. Reinikainen K. J., Keränen T., Halonen T., Komulainen H., Riekkinen P. J. Comparison of oxcarbazepine and carbamazepine: a double-blind study. Epilepsy Res. 1987 Sep;1(5):284–289. doi: 10.1016/0920-1211(87)90003-9. [DOI] [PubMed] [Google Scholar]
  9. Rockliff B. W., Davis E. H. Controlled sequential trials of carbamazepine in trigeminal neuralgia. Arch Neurol. 1966 Aug;15(2):129–136. doi: 10.1001/archneur.1966.00470140019003. [DOI] [PubMed] [Google Scholar]
  10. Schütz H., Feldmann K. F., Faigle J. W., Kriemler H. P., Winkler T. The metabolism of 14C-oxcarbazepine in man. Xenobiotica. 1986 Aug;16(8):769–778. doi: 10.3109/00498258609043567. [DOI] [PubMed] [Google Scholar]
  11. Taylor J. C., Brauer S., Espir M. L. Long-term treatment of trigeminal neuralgia with carbamazepine. Postgrad Med J. 1981 Jan;57(663):16–18. doi: 10.1136/pgmj.57.663.16. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Theisohn M., Heimann G. Disposition of the antiepileptic oxcarbazepine and its metabolites in healthy volunteers. Eur J Clin Pharmacol. 1982;22(6):545–551. doi: 10.1007/BF00609629. [DOI] [PubMed] [Google Scholar]
  13. Tomson T., Tybring G., Bertilsson L., Ekbom K., Rane A. Carbamazepine therapy in trigeminal neuralgia: clinical effects in relation to plasma concentration. Arch Neurol. 1980 Nov;37(11):699–703. doi: 10.1001/archneur.1980.00500600047009. [DOI] [PubMed] [Google Scholar]
  14. Tomson T., Tybring G., Bertilsson L., Ekbom K., Rane A. Carbamazepine therapy in trigeminal neuralgia: clinical effects in relation to plasma concentration. Arch Neurol. 1980 Nov;37(11):699–703. doi: 10.1001/archneur.1980.00500600047009. [DOI] [PubMed] [Google Scholar]
  15. Zakrzewska J. M., Ivanyi L. In vitro lymphocyte proliferation by carbamazepine, carbamazepine-10, 11-epoxide, and oxcarbazepine in the diagnosis of drug-induced hypersensitivity. J Allergy Clin Immunol. 1988 Jul;82(1):110–115. doi: 10.1016/0091-6749(88)90059-0. [DOI] [PubMed] [Google Scholar]
  16. Zigmond A. S., Snaith R. P. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES