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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Loss Of Balance While On Carbamazepine

I am currently on the maximum dose 1600mgs of Carbamazepine. But in recent months I have been having unsteady sensations as if I am going to lose my balance and go in to a fit. I have hade periods like this in the past but nothing like as frequent as at the moment.
posted on Sun, 11 Sep 2016
Twitter Sun, 26 May 2019 Answered on
Twitter Tue, 28 May 2019 Last reviewed on
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Internal Medicine Specialist,  's  Response
Hi,

Carbamazepine can cause Ataxia, Dizziness as a side effect -hence unsteady balance. In the case of disabling unsteadiness, you need to switch over to another anti-convulsant drug according to the type of seizure.

The dose of the second drug should be adjusted to decrease seizure frequency without causing toxicity. Once this is achieved, the first drug can be gradually withdrawn (usually over weeks). The dose of the second drug is then further optimized based on seizure response and side effects. Monotherapy should be the goal whenever possible. Alternatively, Clobazam can be added as an adjuvant drug to reduce the dose of Carbamazepine and hence the toxicity. Pros and cons, you have to discuss with your Neuro physician.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Tushar Kanti Biswas, Internal Medicine Specialist
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Suggest Treatment For Loss Of Balance While On Carbamazepine

Hi, Carbamazepine can cause Ataxia, Dizziness as a side effect -hence unsteady balance. In the case of disabling unsteadiness, you need to switch over to another anti-convulsant drug according to the type of seizure. The dose of the second drug should be adjusted to decrease seizure frequency without causing toxicity. Once this is achieved, the first drug can be gradually withdrawn (usually over weeks). The dose of the second drug is then further optimized based on seizure response and side effects. Monotherapy should be the goal whenever possible. Alternatively, Clobazam can be added as an adjuvant drug to reduce the dose of Carbamazepine and hence the toxicity. Pros and cons, you have to discuss with your Neuro physician. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Tushar Kanti Biswas, Internal Medicine Specialist