Posted by LouisianaSportsman on April 17, 2014, at 3:10:26
In reply to Re: replace Abilify with perphenazine? » Louisiana Sportsman, posted by ed_uk2010 on April 15, 2014, at 13:32:44
> >....why would she need to assess a smaller dosage if she has already responded to that equipotent dosage of the metabolite? I guess you may have a different opinion and that's OK.
>
> Hi,
>
> Oxcarbazepine isn't a metabolite of carbamazepine, but it is structurally closely related, and appears to have a similar mechanism of action. Carbamazepine is metabolised to carbamazepine-10,11-epoxide. Oxcarbazepine is metabolised to eslicarbazepine.
>
> I understand the reasoning behind suggesting a particular drug, but (most) people are not in a position to tell their doctor to prescribe a specific quantity :)Tell? I'm pretty sure everything I say is my opinion and a suggestion. God help people if I tell doctors what to do.
The metabolite of oxcarbamazepine isn't an epoxide so I guess that explains where they reason it has better side effects and why you can't directly convert necessarily. Mentioning Aptom, I wonder if it might be OK for fibromyalgia patients? Pretty new and this derivative of carbamazepine has the most potential.
Regardless, I can't suggest a quantity even though they're both benzo-fluorinated 10,11's and there are existing professional guidelines regarding conversion factors for both drugs, including Aptom. I'm sure the PDOC doesn't know the conversion in head, and why would he not directly convert also? Sounds like she would save him a step.
poster:LouisianaSportsman
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URL: http://www.dr-bob.org/babble/20140328/msgs/1064352.html