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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by KarenK on December 2, 2000, at 10:46:09
My 17 yr old bp son is going to start tegretol next week as soon as the pdoc can wean him off the depakote. How big a risk is the aplastic anemia? Does it sneak up on you so you stand a chance or do you take a pill and die? Sorry but I'm freaking out about this and I don't want my anxiety to jeopardize what might be a successful trial for him.
Any information would be appreciated. Thanks in advance.
Love,
KarenK
Posted by Chris A. on December 2, 2000, at 16:10:34
In reply to Tegretol.. Aplastic Anemia Stories??!!!! PLEEEZ, posted by KarenK on December 2, 2000, at 10:46:09
Karen,
Ask the doc about Trileptal (oxcarbazepine) the cleaned up version of Tegretol. I was never able to tolerate Tegretol, and am doing much better with the Trileptal. It was only FDA approved in the US earlier this year, so many docs are not aware of it. Please insist they check it out.Chris A.
Posted by KarenK on December 2, 2000, at 16:32:51
In reply to Re: Tegretol.. Aplastic Anemia Stories??!!!! PLEEEZ, posted by Chris A. on December 2, 2000, at 16:10:34
Chris,
What kind of problems did you have with tegretol? Thanks for the info on Trileptal.
Karen
> Karen,
> Ask the doc about Trileptal (oxcarbazepine) the cleaned up version of Tegretol. I was never able to tolerate Tegretol, and am doing much better with the Trileptal. It was only FDA approved in the US earlier this year, so many docs are not aware of it. Please insist they check it out.
>
> Chris A.
Posted by Sunnely on December 2, 2000, at 19:10:16
In reply to Tegretol.. Aplastic Anemia Stories??!!!! PLEEEZ, posted by KarenK on December 2, 2000, at 10:46:09
> My 17 yr old bp son is going to start tegretol next week as soon as the pdoc can wean him off the depakote. How big a risk is the aplastic anemia? Does it sneak up on you so you stand a chance or do you take a pill and die? Sorry but I'm freaking out about this and I don't want my anxiety to jeopardize what might be a successful trial for him.
>
> Any information would be appreciated. Thanks in advance.
>
> Love,
> KarenK++++++++++++++++++++++++
Hi Karen,
The bad news: Aplastic anemia is a serious and potentially fatal adverse effect of carbamazepine (Tegretol).
The good news: Tegretol produces aplastic anemia in less than 0.002% of patients, calculated at 2 per million). This is 5-8 times more than the spontaneous rate in the general population.
Another serious blood disorder but fortunately rare that Tegretol causes is agranulocytosis (critically low white blood cell or WBC count). The person becomes defenseless against infection and may succumb to severe infection if the offending drug is not stopped and the condition not treated immediately. Tegretol produces agranulocytosis an estimate of 6 per million.
A mild drop in WBC occurs in about 7-10% initially in patients on Tegretol, but this decrease is usually transitory and without adverse effects.
Patients on Tegretol who develop signs and symptoms of infection such as fever, sore throat, mouth ulcerations, weakness, and/or bleeding tendencies such as easy bruising, purpura, should notify their doctor, stop the drug immediately, and a complete blood count (and coagulation panel) done STAT.
I agree with Chris A. Why not ask the doctor about oxcarbazepine (Trileptal)? It was recently approved by the US FDA as anticonvulsant (for epilepsy) but has shown mood-stabilizing effects (at least in European clinical trials). It has some chemical similarity to Tegretol without its excess "baggage." Compared to Tegretol, Trileptal: 1) has few drug-drug interactions because of its minimal interaction with the CYP450 enzyme system (liver enzymes); 2) does not induce its own metabolism; 3) has no "black box warning;" monitoring of liver enzymes and blood parameters are not required; 4) is quickly and easily titrated (dose increase); 5) generally well tolerated; and 6) can be taken with or without food.
Since 1990, Trileptal has been approved in over 50 countries. It is manufactured by Novartis Pharmaceuticals Corporation.
Posted by Chris A. on December 2, 2000, at 23:20:48
In reply to Re: Tegretol.. Aplastic Anemia Stories??!!!! PLEEEZ, posted by KarenK on December 2, 2000, at 16:32:51
Continuing sedation was the most troubling side effect (which can be good if there are any hypomanic symptoms such as irritability, pressured speech, diminished sleep etc., etc.), but it was not so great for me since chauffering children has been a major part of my job description for a very long time. I also had some easy bruising, so in consultation with my doc discontinued it promptly. It is very nice not to have to worry about regular blood tests, as Sunnely noted. If I were a mother it would take away some of the anxiety even though the major complications are extremely (emphasis on extremely) rare. Adding Trileptal to my med cocktail has brought me greater stability than has been present for a long time. Some people don't experience sedation on Tegretol, but I am very sensitive to it and still have some on Trileptal. We adjust the daytime dosage down somewhat as a result. Depending on the pattern of bipolar, more than one mood stabilizer is often required. Help this answers some questions.
Blessings,
Chris A.
Chris,
>
> What kind of problems did you have with tegretol? Thanks for the info on Trileptal.
>
> Karen
>
> > Karen,
> > Ask the doc about Trileptal (oxcarbazepine) the cleaned up version of Tegretol. I was never able to tolerate Tegretol, and am doing much better with the Trileptal. It was only FDA approved in the US earlier this year, so many docs are not aware of it. Please insist they check it out.
> >
> > Chris A.
Posted by KarenK on December 3, 2000, at 11:27:28
In reply to Re: Tegretol.. Aplastic Anemia Stories??!!!! PLEEEZ, posted by Chris A. on December 2, 2000, at 23:20:48
Chris,
Thanks so much for your help. I checked out the Novartis web site on Trileptal and Tegretol and they warned about taking both if you had sensitivity to tricyclics? My son and I both got very disoriented on tofranil. Do you know anything about that?Anyway he's on lithium and depakote now and he needs another ms because he's hypomanic and has pressured speech as you described so he does need a little slowing down. The pdoc wants to keep the lithium and try another ms. He doesn't feel the depakote is working and I think it may be making my son depressed.
Thanks again. It really helped:))
Love,
Karen
Continuing sedation was the most troubling side effect (which can be good if there are any hypomanic symptoms such as irritability, pressured speech, diminished sleep etc., etc.), but it was not so great for me since chauffering children has been a major part of my job description for a very long time. I also had some easy bruising, so in consultation with my doc discontinued it promptly. It is very nice not to have to worry about regular blood tests, as Sunnely noted. If I were a mother it would take away some of the anxiety even though the major complications are extremely (emphasis on extremely) rare. Adding Trileptal to my med cocktail has brought me greater stability than has been present for a long time. Some people don't experience sedation on Tegretol, but I am very sensitive to it and still have some on Trileptal. We adjust the daytime dosage down somewhat as a result. Depending on the pattern of bipolar, more than one mood stabilizer is often required. Help this answers some questions.
>
> Blessings,
>
> Chris A.
>
>
> Chris,
> >
> > What kind of problems did you have with tegretol? Thanks for the info on Trileptal.
> >
> > Karen
> >
> > > Karen,
> > > Ask the doc about Trileptal (oxcarbazepine) the cleaned up version of Tegretol. I was never able to tolerate Tegretol, and am doing much better with the Trileptal. It was only FDA approved in the US earlier this year, so many docs are not aware of it. Please insist they check it out.
> > >
> > > Chris A.
This is the end of the thread.
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