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Carbamazepine is an anticonvulsant and analgesic small molecule used primarily to treat epilepsy (including partial seizures and generalized tonic-clonic seizures), trigeminal neuralgia (a type of neuropathic pain), and acute manic or mixed episodes in bipolar I disorder. It is also sometimes used off-label for conditions such as alcohol withdrawal syndrome and restless leg syndrome. Carbamazepine acts mainly by binding to voltage-gated sodium channels in their inactive state, thereby inhibiting repetitive neuronal firing and reducing nerve impulses that cause seizures or pain. It may also increase GABA transmission and dopamine turnover in the brain. The drug is metabolized primarily by CYP3A4 into its active metabolite carbamazepine-10,11-epoxide.
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