Combining-Lithium-Carbamazepine

Lithium
Type moodstabilizer
Group other
links
ATC-code N05AN01
Medscape Lithium
PubChem 11125
PubMed Lithium
Drugs.com lithium
Kompas (Dutch) Lithium
Wikipedia Lithium
Carbamazepine
Type moodstabilizer
Group anticonvulsant
links
ATC-code N03AF01
Medscape Carbamazepine
PubChem 2554
PubMed Carbamazepine
Drugs.com carbamazepine
Kompas (Dutch) Carbamazepine
Wikipedia Carbamazepine

Adding carbamazepine to lithium.

Infobord.png General information
  • Lithium is eliminated by the kidney for about 95%. Changes in the rate of excretion can cause unwanted effects.
  • Carbamazepine is principally metabolized by CYP3A4, and is a potent inducer of CYP1A2, CYP2C9, CYP3A4 and UDP-glucuronosyltransferases.
  • The addition of carbamazepine allowes patients to function better while maintaining lower lithium levels.[5]
  • The available data suggest that the combination of lithium and carbamazepine is safe and effective, especially for rapid-cycling patients.[5]
  • Lithium and carbamazepine may work synergistically.[5]
  • Patients receiving both lithium and carbamazepine experience better prophylaxis against bipolar episodes than patients treated with either medication alone.[5]
Eenrichtingbord.png Start carbamazepine
  • Start carbamazepine according to the general dosing advice.
Letopbord.png Cave
  • The combination may rarely cause neurotoxicity without increased plasma levels. [6]
  • The combination of these two drugs is generally safe and effective, but it should be avoided for patients with comorbid CNS (central nervous system) disease. Cases of neurotoxicity and asterixis have been reported with the concomitant use of lithium and carbamazepine.[5]


  1. ↑ 1.01.1 Farmacotherapeutisch Kompas - lithium (dutch) Cite error: Invalid <ref> tag; name "ftk" defined multiple times with different content
  2. ↑ WHO Collaborating Centre for Drug Statistics Methodology ATC=N03AF01
  3. ↑ Farmacotherapeutisch Kompas; Toxicologie (dutch)
  4. ↑ KNMP; Informatorium Medicamentorum 2015; Monografie "carbamazepine" (Dutch)
  5. ↑ 5.05.15.25.35.4 Freeman et al. Mood stabilizer Combinations: A Review of Safety and Efficacy. Am J Psychiatry 1998;155:12-21
  6. ↑ Marcoux AW. Carbamazepine-lithium drug interaction. Ann Pharmacother 1996;30:547
The editors of psychiatrienet.nl take the greatest care to provide up-to-date and accurate information on this site. Nevertheless, mistakes and omissions cannot be entirely excluded. No rights devolve from the information provided. The editors and other providers of information to this site accept no responsibility for the content of this site or for the information provided therein; neither do they accept responsibility for possible damages which may derive from the use of the information on this site or from the linked sites. The editorial board accepts no responsibility for the content of the (linked) sites, for access to them, or for the products and services on these sites, nor for the occurrence of errors, viruses, and/or disruptions in service.