Carbamazepine-, Oxcarbazepine-, Eslicarbazepine-Associated Movement Disorder: A Literature Review

Abstract

Background Carbamazepine (CBZ), oxcarbazepine (OXC), and eslicarbazepine (ESL) acetate belong to the dibenzazepine family. In this context, the aim of this literature review is to evaluate the clinical epidemiological profile, pathological mechanisms, and management of CBZ-, OXC-, and ESL-associated movement disorders (MDs). Review Summary Relevant reports in 6 databases were identified and assessed by 2 reviewers without language restriction. Reports where the individuals only developed tremor or ataxia after CBZ/OXC/ESL use were not included. A total of 73 reports containing 191 individuals who developed MD associated with CBZ/OXC/ESL were identified. Were found, respectively, the following: 33 patients with myoclonus, 23 with dystonia, 14 with tics, 13 with dyskinesia, 8 with parkinsonism, and 5 with akathisia. In the group not clearly defined, there were 44 with myoclonus, 29 with dyskinesia, 20 with dystonia, 1 with incoordination, and 1 with akathisia. The mean age was 28.53 years. The most frequent sex was male in 52.77% (38/72), and the drug indication was epilepsy in 74.19% (69/93). The mean (SD) CBZ dose when the MD occurred was 692.68 (363.58) mg. The mean time until MD onset was 33.59 days, and the mean recovery period was 8.7 days. The most common form of MD management was drug withdrawal. Conclusions The number of cases associated with CBZ is higher than those with OXC + ESL. We believe that the study of CBZ contributes not only to the improvement of this drug but also to the knowledge about the drug-induced MD of OXC and ESL. In the literature, the description of the MD onset and recovery has been poorly reported.

Pregabalin-associated movement disorders: A literature review

“…When provided, we extracted author, department, year of publication, country of occurrence, number of patients affected, PGB indication, time from first PGB dose till MD onset, time from PGB withdrawal to symptom improvement, patient's status at follow-up, and important findings of clinical history and management. [ 11 12 13 ] Most of the cases did not report information about timeline events, neurological examination details, or electrodiagnostic studies. Data were extracted by two independent authors, double-checked to ensure matching, and organized by whether the MD was a side effect of the PGB use.…”

Treatable Hyperkinetic Movement Disorders Not to Be Missed

“…Carbamazepine can, also, occasionally be a cause of akathisia. Antiepileptics such as Lamotrigine, Carbamazepine, and Oxcarbazine have been reported to cause tics (129,(162)(163)(164)(165).…”

“…CBZ can be prescribed in the same patients already under Lithium, as it is also a mood stabilizer. The co-prescription can not only increase the risk of ataxia due to the sodium channel blocking properties of CBZ, but also increase the risk of hyperkinetic movements, as for instance myoclonus and dystonia, which are the most frequently reported with CBZ and its derivative oxcarbazepine ( 162 ).…”

Precision medicine for genetic childhood movement disorders

“…41 The exact mechanism of carbamazepine efficacy in PKD has not yet been fully elucidated but may relate to its voltage-gated sodium channel blockage properties or possibly to inhibition of dopamine neurotransmission from increased striatal acetylcholine concentrations. 42…”