Posted by ed_uk2010 on April 18, 2014, at 11:02:18
In reply to Re: replace Abilify with perphenazine?, posted by LouisianaSportsman on April 17, 2014, at 3:10:26
> > >....why would she need to assess a smaller dosage if she has already responded to that equipotent dosage of the metabolite? I guess you may have a different opinion and that's OK.
> >
> > Hi,
> >
> > Oxcarbazepine isn't a metabolite of carbamazepine, but it is structurally closely related, and appears to have a similar mechanism of action. Carbamazepine is metabolised to carbamazepine-10,11-epoxide. Oxcarbazepine is metabolised to eslicarbazepine.
> >
> > I understand the reasoning behind suggesting a particular drug, but (most) people are not in a position to tell their doctor to prescribe a specific quantity :)
>
>Mentioning Aptom, I wonder if it might be OK for fibromyalgia patients? Pretty new and this derivative of carbamazepine has the most potential.I think the main benefit of eslicarbazepine acetate (Aptiom, Zebinix) over oxcarbazepine (Trileptal) is convenience ie. once daily dosing and simple titration. In terms of efficacy and tolerability, there two meds are probably very similar. I wouldn't be surprised if the cost of Aptiom was prohibitive in some cases.
Carbamazepine and oxcarbazepine haven't been used a great deal in fibromyalgia - I don't think eslicarbazepine offers much promise here either. Eslicarbazepine might potentially be useful in bipolar disorder but I'd like to see some major trials comparing it with established meds such as Depakote and lithium. It might also be useful in trigeminal neuralgia.
Conversion from carbamazepine to oxcarbazepine may depend on the dose of carbamazepine which was taken, due to auto-induction of hepatic enzymes. It may also depend on which formulation of carbamazepine was taken eg. standard release or sustained release.
poster:ed_uk2010
thread:1063976
URL: http://www.dr-bob.org/babble/20140328/msgs/1064429.html