Oxcarbazepine in the bipolar and schizoaffective disorders

Abstract

Starting in the 1970s with valproate and carbamazepine several anticonvulsant drugs have been established as treatment option in bipolar disorder. Level I of evidence based medicine confirm the efficacy of valproate and carbamazepine in the treatment of mania but their role in maintenance therapy is less clear than of lithium. Level I of evidence based medicine also confirm the efficacy of lamotrigine in the treatment of depression and in the maintenance therapy of bipolar disorder. Oxcarbazepine is a chemical keto-derivative of carbamazepina with a similar structure and antiepileptic profile. Oxcarbazepine has less severe adverse effects and less pharmacological interactions than carbamazepine and valproate. The available evidence suggest that oxcarbazepine may be effective in the treatment of mania and in the maintenance treatment of bipolar disorder. Further double-blind placebo controlled studies are needed for confirm this statement.