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As we write in the bipolar child, because tegretol activates certain enzymes in the liver, and this causes the drug itself and many others to be metabolized faster, the serum tegretol level may drop somewhat after the first month of treatment, requiring increased doses based on blood levels.

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Treatment of Blood Count AbnormalitiesIf evidence of significant bone marrow depression developsthe following recommendations are suggested1stop the drug2perform daily CBCplateletand reticulocyte counts3do a bone marrow aspiration and trephine biopsy immediately and repeat with sufficient frequency to monitor recovery.

No evidence of abuse potential has been associated with Tegretolnor is there evidence of psychological or physical dependence in humans.

The most frequently observed adverse reactionsparticularly during the initial phases of therapyare dizzinessdrowsinessunsteadinessnauseaand vomitingTo minimize the possibility of such reactionstherapy should be initiated at the lowest dosage recommended.

If adverse reactions are of such severity that the drug must be discontinuedthe physician must be aware that abrupt discontinuation of any anticonvulsant drug in a responsive epileptic patient may lead to seizures or even status epilepticus with its life-threatening hazards.

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