Carbamazepine Extended Release Has Mixed Effects in Bipolar Children

November 8, 2010 · Posted in Potential Treatments · Comment 

In a poster presentation at the Pediatric Bipolar Conference in Cambridge, Massachusetts in March, Gagin Joshi from Massachusetts General Hospital (MGH) presented positive data from a study on the use of carbamazepine extended release (Equetro) in 27 children ages 6 to 12 with childhood-onset bipolar illness. These data were published this year in the Journal of Child and Adolescent Psychopharmacology.

Joshi found substantial overall improvement using an average dose of 788 mg/day, achieving blood levels averaging 6.6 mcg/l. Surprisingly, antidepressant effects were as robust as antimanic effects.

Major side effects included headache in 23% of participants, gastrointestinal upset in 18%, sedation in 15%, and dizziness in 8%. However, eleven children dropped out of the study prematurely (two for rash, three for mania, three for lack of efficacy, and three who did not participate in follow up). Joshi felt that carbamazepine extended release was a useful backup strategy, but he was not overly impressed with its overall profile in children, in part because of the high dropout rate.