Trileptal for Bipolar Disorder: Research, Dosage, and Side Effects - PsychCentral.com

Trileptal may be an effective treatment for bipolar disorder, but more research is needed to support its benefits.

Trileptal (brand name of the generic drug oxcarbazepine) is an antiseizure drug that doctors routinely prescribe as a second-line option to control seizures in adults and children.

Some research suggests Tripeltal could also help treat symptoms of bipolar disorder, and it's sometimes used off-label for this purpose. However, more studies are needed before experts know its true benefits and risks when used in this way.

Bipolar disorder involves episodes of mania, depression, or both. Treatment plans often include talk therapy along with medications, which might include a mood stabilizer, an antiseizure medication, or an antipsychotic.

Medical professionals may prescribe Trileptal for the following conditions:

• seizures in adults and children
• trigeminal neuralgia (severe facial pain) in multiple sclerosis
• maintenance treatment of bipolar disorder

However, the Food and Drug Administration (FDA) has not approved Trileptal for bipolar disorder or trigeminal neuralgia, as research is generally lacking for both conditions. It's only been FDA-approved for use in adult and childhood seizure disorders.

Trileptal has a similar action as carbamazepine, which is the drug it's derived from. Carbamazepine has been studied more than Trileptal as a potential treatment for bipolar disorder. As a result, carbamazepine was previously approved by the FDA for hypomania, mild-to-moderate mania, and bipolar disorder with mixed features.

Recent research on Trileptal's effectiveness for bipolar disorder is very limited. Most of the research for both Trileptal and carbamazepine on bipolar disorder was performed in the 1980s and 1990s.

However, a 2022 study looked at the use of oxcarbazepine in people with bipolar disorder who were hospitalized during episodes of mania. They were given between 900 mg and 2400 mg of oxcarbazepine per day, or they were given sodium valproate. The researchers reported similar improvements in mania symptoms over a 6-week period for both drugs.

Additionally, findings from a 2021 literature review indicated the following potential benefits of oxcarbazepine for bipolar disorder:

• may be effective for mild-to-moderate mania
• may have mild-to-moderate effectiveness for depressive episodes
• may be useful as an add-on therapy
• may be particularly helpful for hostile behavior

Researchers noted that in addition to more studies, better quality studies are needed to confirm these potential benefits.

First-line treatments for bipolar disorder commonly include antipsychotics or mood stabilizers, which alter certain mood-related brain chemicals like dopamine. Antiseizure drugs like Trileptal are used less frequently, but can also be considered.

Valproate is a well-known antiseizure drug that doctors more commonly give people for mania in bipolar disorder.

Similar to Valproate, Trileptal works by lowering the amount of sodium in your brain. Sodium plays a critical role in the nervous system, helping nerve impulses carry throughout the body.

By altering sodium levels, Trileptal is thought to slow down the rate of nerve impulses between the neurons in the brain. This helps explain its effectiveness for seizures, where nerve impulses are overactive.

But like Valproate, researchers aren't exactly sure why Trileptal is potentially effective for bipolar disorder.

Since Trileptal is not FDA-approved for use in bipolar disorder, there are no standard dosage recommendations.

According to the National Alliance on Mental Illness, the typical dose range for oxcarbazepine is 900–1200 mg. People will usually begin at a low dose, then increase the dose slowly over a few weeks. If you take this medication for seizures, you may take up to 2400 mg per day.

The most common side effects of Trileptal or oxcarbazepine are:

• dizziness
• confusion
• fatigue
• rash
• visual changes
• nausea or vomiting
• headache
• uncoordinated body movements

More serious side effects can also include:

Low sodium is a particularly concerning symptom. It can cause serious complications such as seizures. If you're interested in trying Trileptal, your doctor will check your sodium levels routinely, especially during the first 3 months of use.

Additionally, if you want to stop using Trileptal, it's important to talk with your provider first. It is unsafe to abruptly discontinue this medication.

Although it's sometimes used off-label for bipolar disorder, it seems that Trileptal has a long way to go before it gains FDA approval.

If you're living with bipolar disorder and are searching for treatment options, you can talk with a healthcare professional about all of your choices.

To learn more about bipolar disorder and for additional help, you can: