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carbamazepine (carbamazepine, Elan / Bipotrol / Carbatrol)

✓ Approved

Shire · SCN1A · Small Molecule

What is carbamazepine?

carbamazepine is a small molecule developed by Shire. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand Namescarbamazepine, Elan, Bipotrol, Carbatrol
CompanyShire
Drug ClassSmall Molecule
Molecular TargetSCN1A, SCN2A, SCN3A
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, Shire

Mechanism of Action

Molecular Targets

carbamazepine acts on 3 molecular targets:

SCN1Asodium voltage-gated channel alpha subunit 1 (DEE6B, FEB3)
SCN2Asodium voltage-gated channel alpha subunit 2 (Na(v)1.2, BFNIS)
SCN3Asodium voltage-gated channel alpha subunit 3 (Nav1.3, NAC3)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

carbamazepine is developed for 3 unique indications across 2 therapeutic areas.

Therapeutic AreaConditionPhase
Nervous system disordersEpilepsy✓ Approved
Nervous system disordersTrigeminal neuralgia✓ Approved
Psychiatric disordersBipolar disorder✓ Approved

Related Research Articles

PubMedBioorganic chemistry2026-10-20

Design, synthesis, and pharmacological evaluation of 7-substituted 1,2,4-triazolo[1,5-a]pyrimidine derivatives as novel antiepileptic lead candidates targeting Nav1.2 channels.

He Luqian L, Zhang Qiaoliang Q, Ma Wenjuan W, Qian Meiqi M et al.

The limitations of current antiepileptic drugs, including drug resistance and adverse effects, necessitate the development of novel therapeutic agents with improved efficacy and safety. Herein, we describe the design, synthesis, and pharmacological evaluation of a series of novel 1,2,4-triazolo[1,5-a]pyrimidine derivatives. Through strategic modification at the C-7 position, we identified compound 5m as a highly potent anticonvulsant agent. In the pentylenetetrazole (PTZ) epilepsy model, 5m exhibited exceptional antiseizure activity (ED50 = 8.84 mg/kg) with a high protective index (PI > 14.80), demonstrating superior efficacy and safety profiles compared to valproate, carbamazepine, and phenobarbital. Notably, 5m showed no neurotoxicity at its maximum soluble concentration. Preliminary structure-activity relationship (SAR) analysis at the C-7 position suggested that the trifluoromethanesulfonate substituent, the pyrimidine nitrogen atoms, and the ortho-fluoro substitution pattern on the phenyl ring are important for potent activity. Mechanism of action studies combining electrophysiological patch-clamp recordings and molecular docking simulations established Nav1.2 channels as a primary molecular target, with 5m exhibiting inhibitory activity against Nav1.2 channels (23% ± 17% inhibition at 10 μM) and forming key interactions with residues LEU329, LEU336, ASN388, GLN391, and ARG395, while showing no significant effect on GABAA receptors. Furthermore, in silico ADMET prediction confirmed that 5m possesses excellent drug-like properties, including favorable gastrointestinal absorption and blood-brain barrier permeability, with no predicted toxicity. In summary, compound 5m represents a promising novel antiepileptic lead candidate with high efficacy, low neurotoxicity, and a favorable drug-like profile, warranting further preclinical development.

PMID 42901000
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PubMedNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2026-10-18

TAC-Tic syndromes: a case series on the complex overlap between trigeminal autonomic cephalalgias and trigeminal neuralgia.

de Sousa Pelliciari Davy Henrique DH, Garcia Larissa Aguiar LA, Bordini Carlos Alberto CA, Ribeiro Jaqueline Silva JS

Trigeminal autonomic cephalalgias (TACs) and trigeminal neuralgia (TN) are classified as distinct disorders, although overlap syndromes are increasingly recognized. We retrospectively describe five women with TAC-tic overlap: two with SUNCT-tic, two with cluster-tic, and one with paroxysmal hemicrania-tic syndrome. Each had distinguishable neuralgic and autonomic pain phenotypes, appearing either simultaneously or sequentially. In both SUNCT-tic cases, repeat imaging disclosed neurovascular compression after an initially negative study; microvascular decompression produced complete remission of both phenotypes. Cluster-tic presentations were controlled with peripheral nerve blocks, carbamazepine, and verapamil. In the paroxysmal hemicrania-tic case, the autonomic component responded to indomethacin whereas the neuralgic component required neuromodulator adjustment. The opposite order of phenotype emergence in the SUNCT-tic cases, together with shifts in the dominant phenotype during treatment, supports bidirectional temporal plasticity. Convergence of trigeminal and upper cervical afferents in the trigeminocervical complex offers a plausible link between peripheral input, the trigeminal-autonomic reflex, and the observed response to occipital nerve blocks. TAC-tic syndromes are rare and probably underrecognized. Repeated phenotyping, imaging tailored to the trigeminal root when clinically indicated, and treatment directed at each component may improve clinical control.

PMID 42891854
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PubMedCureus2026-10-17

Giant Mixed-Material Gastric Bezoar With a Synchronous Jejunal Bezoar in a Young Woman With Pica and Autism Spectrum Disorder: A Case Report.

Suárez Fuentes Sergio Miguel SM, Cardenas Mauro A MA, Gomez Marquez Valeria V, Hernández González Luis F LF et al.

Bezoars are conglomerates of indigestible material retained within the gastrointestinal tract and may produce obstruction, ulceration, bleeding, or perforation. Mixed-material bezoars containing nonfood foreign bodies are uncommon and may be particularly challenging in patients with persistent pica. We report a 21-year-old woman with autism spectrum disorder (ASD), mild intellectual disability, previously diagnosed pica, and a seizure disorder treated with carbamazepine who presented after nearly one month of recurrent fever, colicky abdominal pain, progressive distension, early satiety, constipation, and nonbilious alimentary vomiting. Examination demonstrated abdominal distension and a firm, poorly defined epigastric-mesogastric mass without peritoneal irritation. Leukocytosis with neutrophilia was present. Abdominal radiography showed marked gastromegaly with mottled intragastric radiolucency, and computed tomography (CT) demonstrated a stomach almost completely occupied by heterogeneous solid material. Upper endoscopy confirmed a large gastric foreign-body mass. Exploratory laparotomy revealed marked gastromegaly and, unexpectedly, a separate bezoar obstructing the proximal jejunum that had not been identified preoperatively. A 15-cm anterior gastrotomy permitted removal of 3,000 g of material, and a 5-cm antimesenteric jejunotomy permitted removal of an additional 500 g. The two masses were not physically connected and contained plastic bags and bottle fragments, plastic caps, candy wrappers, adhesive tape, hair, plant fibers, and metallic staples. Both enteric incisions were closed in two layers, with an outer Lembert layer. Oral liquids were initiated on postoperative day 5 and advanced as tolerated; the patient was discharged on postoperative day 8 without leak, infection, or other surgical complications. Follow-up at one week after discharge and at one month showed favorable recovery. This case highlights the diagnostic importance of considering synchronous distal bezoars in patients with severe pica and a massive gastric bezoar, particularly when preoperative imaging identifies only the dominant gastric lesion.

PMID 42890848
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PubMedJournal of clinical medicine2026-10-16

Male Reproductive Disorders Associated with Antiseizure Medications: Evidence from Meta-Analysis and FAERS Pharmacovigilance Study.

Na Heejin H, Choi Boyoon B, Oh Se-Hoon SH, Jo In-Je IJ et al.

Background/Objectives: Antiseizure medications (ASMs) are widely used in the management of epilepsy; however, their effects on male reproductive function in humans remain incompletely characterized. This study aimed to evaluate drug-specific associations between ASMs and male reproductive disorders through a meta-analysis of observational clinical studies and FDA Adverse Event Reporting System (FAERS)-based pharmacovigilance analyses. Methods: Clinical studies involving men with epilepsy receiving ASMs, untreated men with epilepsy, and healthy controls were systematically reviewed and quantitatively synthesized. FAERS reports from the first quarter of 2019 to the second quarter of 2026 (2019Q1-2026Q2) were analyzed using reporting odds ratios (RORs) and information components (ICs), with disproportionality signals identified by either method. Results: The meta-analysis included 20 clinical studies involving 1530 participants. Valproate was associated with adverse effects on reproductive hormones, sperm parameters, and sexual function, whereas carbamazepine and phenytoin were primarily associated with alterations in reproductive hormone levels. In the pharmacovigilance analysis, valproate showed a significant disproportionality signal for male reproductive disorders (IC025 1.792). Conclusions: The findings indicate that male reproductive effects are not uniform across ASMs but exhibit distinct drug-specific patterns. Valproate was associated with alterations across multiple reproductive domains, whereas carbamazepine and phenytoin were associated predominantly with reproductive hormone alterations. Reproductive health should be considered when selecting and monitoring long-term ASM therapy in men, and prospective studies are needed to further characterize the reproductive safety profiles of individual ASMs.

PMID 42882028
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PubMedAnalytica chimica acta2026-10-16

Digitally plotted graphene oxide-modified paper for syringe-assisted micro-solid-phase extraction of antiepileptic drugs in rat blood.

Manmana Yanawut Y, Nuchtavorn Nantana N

Graphene oxide (GO) has considerable potential as a sorbent for solid-phase extraction because it interacts strongly with aromatic compounds, yet practical use can be hindered by difficulties in handling GO powder and reproducibly immobilizing it on solid supports. Cellulose paper is an attractive low-cost substrate, although conventional coating methods may yield uneven deposition. Digital plotting offers a straightforward way to place GO onto paper with controlled deposition and without complicated chemical modification. Accordingly, this study addressed the need for a reproducibly fabricated GO-paper sorbent that could be incorporated into a simple flow-through micro-solid-phase extraction (μ-SPE) system for bioanalytical sample preparation. GO-modified cellulose paper was prepared with a commercial digital plotter, providing uniform and reproducible sorbent substrates. Initial screening of ten aromatic organic compounds led to the selection of carbamazepine and oxcarbazepine as model analytes. The optimized conditions were pH 6.0-7.5, a 5-min extraction period, and two GO layers. For spiked rat blood, 1 mL of sample underwent protein precipitation with 80% acetonitrile before GO-based extraction, followed by elution with 500 μL of 1% formic acid in acetonitrile. Placing the GO-modified paper in a syringe filter holder enabled syringe-assisted flow-through μ-SPE, with sample passage completed in approximately 30 s. Analysis by sweeping-micellar electrokinetic chromatography yielded recoveries of 87.5 ± 4.0 to 90.3 ± 3.1% for carbamazepine and 85.5 ± 4.7 to 89.1 ± 3.6% for oxcarbazepine. This work is novel in integrating digitally controlled GO deposition on cellulose paper with a syringe-assisted flow-through μ-SPE configuration. The resulting approach combines reproducible sorbent preparation with rapid sample handling, low sorbent and solvent requirements, and effective cleanup of pretreated blood samples. It therefore shows the potential of digitally fabricated GO-paper sorbents as a simple and accessible platform for bioanalytical sample preparation.

PMID 42887983
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PubMedPaediatric drugs2026-10-15

Pharmacological Interventions for Acute Stress Disorder and for the Prevention and Treatment of Post-traumatic Stress Disorder in Children and Adolescents: A Narrative Review.

Tesnières Charles C, Kerbage Hala H, Bui Eric E, Rolling Julie J

Traumatic events are common during childhood and adolescence and may lead to acute stress disorder (ASD) or post-traumatic stress disorder (PTSD), both associated with developmental, cognitive and functional impairment. Although trauma-focused psychotherapies are recommended as first-line treatments, pharmacological interventions are frequently used in clinical practice despite limited evidence in paediatric populations. To review the evidence on pharmacological interventions for the prevention and treatment of paediatric ASD and PTSD, we reviewed the literature published up to December 2025. Eligible studies included participants aged younger than 18 years and evaluated pharmacological interventions targeting ASD, PTSD prevention or PTSD treatment. After screening and a full-text review, 75 publications were included. Given the methodological heterogeneity, findings were synthesised narratively. Evidence for pharmacological interventions in paediatric trauma-related disorders remains limited and heterogeneous. For PTSD prevention, only limited data support sertraline and, in the context of ASD, imipramine. Limited data also suggest that opioids used for pain management after trauma may reduce subsequent PTSD risk. Early opioid (morphine) exposure for pain management was also associated with lower subsequent severity symptoms in observational paediatric burn studies. Evidence for PTSD treatment is weaker. Anticonvulsants (sodium valproate, carbamazepine, oxcarbazepine, lamotrigine), antipsychotics (clozapine, quetiapine, aripiprazole), glutamatergics (D-cycloserine, ketamine, ifenprodil), propranolol and cannabidiol do not appear to provide sufficient benefit for routine use. Alpha-adrenergic agents (prazosin, clonidine, guanfacine) have shown preliminary signals of benefit, particularly for hyperarousal and trauma-related sleep disturbances. However, these findings are based on non-randomised and uncontrolled studies. Antidepressants (sertraline, citalopram) show mixed results; among them, citalopram was associated with symptomatic improvement in one small open-label study and one case series. These findings should be considered preliminary and hypothesis generating. No pharmacological treatment has sufficient evidence to warrant routine recommendation for paediatric PTSD and ASD. Pharmacotherapy should therefore be considered only as an adjunct to trauma-focused psychotherapy in selected clinical situations. Further randomised controlled trials are needed.

PMID 42879122
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