Carbamazepine

usage profile, associated medications, adverse events, and treatment adherence - a cross-sectional study*

Authors

Keywords:

Epilepsy, Patient Health Questionnaire, Prescription Drugs, Polypharmacy, Mood Disorders

Abstract

Objective: To describe the profile, associated medications, potential adverse events (AE), anxiety levels, and treatment adherence among carbamazepine (CBZ) users.

Methods: Cross-sectional, descriptive, and analytical study conducted through a questionnaire and consultation of secondary data in medical records. The study was conducted in the public health system of the municipality of Ijuí.

Results: 45.9% of participants used carbamazepine for some mood disorder and 35.3% for epilepsy. 60% of the population reported adverse events, and 20% believed these were associated with the use of carbamazepine. Drowsiness (40%) and dizziness (35.3%) were the most frequent adverse events. 51.8% of participants were considered polypharmacy users. Only 3.5% of respondents were considered fully adherent to treatment.

Conclusion: It was possible to identify the profile of carbamazepine users, contributing to the understanding of the topic, given that there are few studies on this population in the literature.

Author Biographies

Karine Raquel Uhdich Kleibert, Regional University of the Northwest of the State of Rio Grande do Sul, Ijuí, RS, Brazil.

Pharmacist. Master's degree in Comprehensive Health Care, Regional University of the Northwest of the State of Rio Grande do Sul, Ijuí, RS, Brazil.

 

Alana Thais Gisch Andres, Regional University of the Northwest of the State of Rio Grande do Sul, Ijuí, RS, Brazil.

Pharmacist. Master's degree in Comprehensive Health Care, Regional University of the Northwest of the State of Rio Grande do Sul, Ijuí, RS, Brazil.

Lenara Schalanski Krause, Regional University of the Northwest of the State of Rio Grande do Sul, Ijuí, RS, Brazil.

Pharmacist. Master's degree in Comprehensive Health Care, Regional University of the Northwest of the State of Rio Grande do Sul, Ijuí, RS, Brazil.

Viviane Fereira de Melo, Regional University of the Northwest of the State of Rio Grande do Sul, Ijuí, RS, Brazil.

Nutritionist. Master's degree in Environmental Systems and Sustainability, Regional University of the Northwest of the State of Rio Grande do Sul, Ijuí, RS, Brazil.

Adriane Cristina Bernat Kolankiewicz, Regional University of Northwest Rio Grande do Sul State, Ijuí, RS, Brazil.

Nurse. PhD in Sciences, Professor at the Regional University of Northwest Rio Grande do Sul State, Ijuí, RS, Brazil.

Mariana Rodriges Botton, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.

Pharmacist. PhD in Genetics and Molecular Biology. Professor at the Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.

Christiane de Fátima Colet, Regional University of the Northwest of the State of Rio Grande do Sul, Ijuí, RS, Brazil.

Pharmacist. PhD in Pharmaceutical Sciences, Professor at the Regional University of the Northwest of the State of Rio Grande do Sul, Ijuí, RS, Brazil.

References

1. Boaventura V, Lyrio RR, Nardi AE, Cheniaux E. Carbamazepine in the treatment of bipolar disorder: a systematic review. J Bras Psiquiatr [Internet]. 2023 [cited 2024 Jan 19];72(4)247-55. Available from: https://doi.org/10.1590/0047-2085000000434

2. Rang HP, Ritter JM, Flower RJ, Henderson G. Farmacología. 9th ed. S.L.U: Elsevier España; 2020. 808 p.

3. Chan AYL, Yuen ASC, Hsia Y, Lau WCY, Cross JH, Walker MC, et al. Antiseizure medications consumption in 73 countries and regions from 2012 to 2022: a longitudinal trend study. eClinicalMedicine [Internet]. 2025 [cited 2024 Jan 19];89:103558. Available from: https://doi.org/10.1016/j.eclinm.2025.103558

4. Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde; Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Portaria conjunta nº 17, de 21 de junho de 2018. Aprova o protocolo clínico e diretrizes terapêuticas da epilepsia [Internet]. Brasília (DF): Ministério da Saúde; 2018 [citado 2024 Jan 19]. Available from: https://www.gov.br/conitec/pt-br/midias/protocolos/pcdt_epilepisia_2019.pdf/view

5. Katzung BG, Trevor AJ. Farmacologia básica e clínica. 15th ed. Porto Alegre: AMGH Editora Ltda; 2023. 1328 p.

6. Kalinina D, Aimyshev T, Muxunov A, Utebekov Z, Kyrgyzbay G, Kimadiev D, et al. Prescription patterns of antiseizure medication in adult patients with epilepsy in kazakhstan (2021-2023). Med Sci (Basel) [Internet]. 2025 [cited 2024 Jan 19];13(4):276. Available from: https://doi.org/10.3390/medsci13040276

7. Silva SN, Lima MG, Ruas CM. Uso de medicamentos nos Centros de Atenção Psicossocial: análise das prescrições e perfil dos usuários em diferentes modalidades do serviço. Ciênc Saúde Colet [Internet]. 2020 [cited 2024 Jan 20];25(7):2872-82. Available from: https://doi.org/10.1590/1413-81232020257.23102018

8. Zanetti LL, Stumm E, Bosse FG, Oliveira R, Bandeira VAC, Colet CF. Tratamento medicamentoso e não medicamentoso de usuários de um Centro de Atenção Psicossocial. Sci Med [Internet]. 2017 [cited 2024 Jan 19];27(4):28277. Available from: https://doi.org/10.15448/1980-6108.2017.4.28277

9. Fadare JO, Sunmonu TA, Bankole IA, Adekeye KA, Abubakar SA. Medication adherence and adverse effect profile of antiepileptic drugs in Nigerian patients with epilepsy. Neurodegener Dis Manag [Internet]. 2018 [cited 2025 Aug 18];8(1):25-36. Available from: https://doi.org/10.2217/nmt-2017-0044

10. Shumet S, Wondie M, Ayano G, Asfaw H, Kassew T, Mesafint G. Antiepileptic drug adherence and its associated factors among epilepsy patients on follow-ups at amanuel mental specialized hospital: Ethiopia. Ethiop J Health Sci [Internet]. 2022 [cited 2024 Jan 19];32(5):913-22. Available from: https://doi.org/10.4314/ejhs.v32i5.6

11. Ogunjimi L, Alabi A, Aderinola A, Ogunjimi O, Oladunjoye Y, Kasali A, et al. Predictors and associated factors with adverse drug reaction in people with epilepsy. Epilepsy Behav [Internet]. 2024 [cited 2024 Jan 20];150:109152. Available from: https://doi.org/10.1016/j.yebeh.2023.109566

12. Ben AJ, Neumann CR, Mengue SS. Teste de Morisky-Green e brief medication questionnaire para avaliar adesão a medicamentos. Rev Saúde Pública [Internet]. 2012 [cited 2024 Jan 19];46(2):279-89. Available from: https://doi.org/10.1590/S0034-89102012005000013

13. WHO Collaborating Centre for Drug Statistics Methodology. ATC/DDD Index [Internet]. Oslo: Norwegian Institute of Public Health; 2026 [cited 2022 May 2]. Available from: https://www.whocc.no/atc_ddd_index/?code=N03AF01

14. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol [Internet]. 1988 [cited 2024 Jan 13];56(6):893-7. Available from: https://doi.org/10.1037//0022-006x.56.6.893

15. Machado-Alba JE, Calvo-Torres LF, García-Betancur S, Aguirre-Novoa A, Bañol-Giraldo AM. Drug utilisation study in patients receiving antiepileptic drugs in Colombia. Neurologia [Internet]. 2016 [cited 2024 Jan 20];31(2):89-96. Available from: https://doi.org/10.1016/j.nrleng.2015.06.002

16. Al-Taani GM, Yehya A, Albals D, Alsous M. Assessment of adherence to carbamazepine using plasma and saliva samples, a study from Jordan. Heliyon [Internet]. 2024 [cited 2024 Jan 19];10(5):e26736. Available from: https://doi.org/10.1016/j.heliyon.2024.e26736

17. Elhosary MY, Merranko JA, Goldstein TR, Hafeman DM, Goldstein BI, Gill MK, et al. Examining Factors Associated With Medication Adherence in Youth With Bipolar Disorder. JAACAP Open [Internet]. 2023 [cited 2024 Jan 19];1(2):105-15. Available from: https://doi.org/10.1016/j.jaacop.2023.06.001

18. Baldessarini R, Henk H, Sklar A, Chang J, Leahy L. Psychotropic medications for patients with bipolar disorder in the United States: polytherapy and adherence. Psychiatr Serv [Internet]. 2008 [cited 2025 Aug 18];59(10):1175-83. Available from: https://doi.org/10.1176/ps.2008.59.10.1175

19. Benatti B, Girone N, Conti D, Cocchi M, Achilli F, Leo S, et al. The Role of lifestyle on adherence to treatment in a sample of patients with unipolar and bipolar depression. Int J Environ Res Public Health [Internet]. 2023 [cited 2026 Jan 13];20(3):1994. Available from: https://doi.org/10.3390/ijerph20031994

20. Patel S, Huang M, Miliara S. Understanding treatment adherence in chronic diseases: challenges, consequences, and strategies for improvement. J Clin Med [Internet]. 2025 [cited 2024 Jan 19];14(17):6034. Available from: https://doi.org/10.3390/jcm14176034

21. Agência Nacional de Vigilância Sanitária (Anvisa). Bula do Carbamazepina. Anvisa [Internet]. 2022 [cited 2022 May 5]. Available from: https://consultaremedios.com.br/carbamazepina/bula

22. Injar I, Keezer M, Lapalme-Remis S, Chamelian L, Assi EB, Nguyen DK. Screening and Management of Depression and Anxiety in People With Epilepsy: A Quality Improvement Study. Can J Neurol Sci [Internet]. 2025 [cited 2026 Jan 13]1-9. Available from: https://doi.org/10.1017/cjn.2025.10491

23. Gómez-Arias B, Crail-Meléndez D, López-Zapata R, Martínez-Juárez IE. Severity of anxiety and depression are related to a higher perception of adverse effects of antiepileptic drugs. Seizure [Internet]. 2012 [cited 2024 Feb 14];21(8):588-94. Available from: https://doi.org/10.1016/j.seizure.2012.06.003

24. Nevitt SJ, Sudell M, Cividini S, Marson AG, Tudur Smith C. Antiepileptic drug monotherapy for epilepsy: a network meta-analysis of individual participant data. Cochrane Database of Systematic Reviews [Internet]. 2022 [cited 2024 Jan 19];(4)CD011412. Available from: http://doi.wiley.com/10.1002/14651858.CD011412.pub4

25. Malta DC, Bernal RTI, Prates EJS, de Vasconcelos NM, Gomes CS, Stopa SR, et al. Self-reported arterial hypertension, use of health services and guidelines for care in Brazilian population: National Health Survey, 2019. Epidemiol Serv Saúde [Internet]. 2022 [cited 2024 Feb 24];31(nspe1):e2021369. Available from: https://doi.org/10.1590/SS2237-9622202200012.especial

26. Rolim CHS, Carneiro RG, de Araújo FJ. Análise do consumo de medicamentos psicotrópicos em Unidades Básicas de Saúde. Rev Contexto Saúde [Internet]. 2023 [cited 2024 Jan 21];23(47):e13272. Available from: https://doi.org/10.21527/2176-7114.2023.47.13272

27. Trinka E, Rocamora R, Chaves J, Koepp MJ, Rüegg S, Holtkamp M, et al. Lipid profile with eslicarbazepine acetate and carbamazepine monotherapy in adult patients with newly diagnosed focal seizures: post hoc analysis of a phase III trial and open-label extension study. Ther Adv Neurol Disord [Internet]. 2023 [cited 2026 Jan 13];16:17562864231193530. Available from: https://doi.org/10.1177/17562864231193530

28. Gibbons GF. The role of cytochrome P450 in the regulation of cholesterol biosynthesis. Lipids [Internet]. 2002 [cited 2024 Aug 18];37(12):1163-70. Available from: https://doi.org/10.1007/s11745-002-1016-x

29. Xin J, Yan S, Hong X, Zhang H, Zha J. Environmentally relevant concentrations of carbamazepine induced lipid metabolism disorder of Chinese rare minnow (Gobiocypris rarus) in a gender-specific pattern. Chemosphere [Internet]. 2021 [cited 2024 Jan 21];265:129080. Available from: https://doi.org/10.1016/j.chemosphere.2020.129080

30. Uskur T, Güven O. Therapeutic drug monitoring of carbamazepine and valproic acid: interindividual variability in epilepsy patients. J Health Sci Med [Internet]. 2025 [cited 2024 Jan 19];8(5):884-8. Available from: https://doi.org/10.32322/jhsm.1751139

Downloads

Published

2026-04-23

How to Cite

Kleibert, K. R. U., Andres, A. T. G., Krause, L. S., de Melo, V. F., Kolankiewicz, A. C. B., Botton, M. R., & Colet, C. de F. (2026). Carbamazepine: usage profile, associated medications, adverse events, and treatment adherence - a cross-sectional study*. Cogitare Enfermagem, 31. Retrieved from https://revistas.ufpr.br/cogitare/article/view/100997

Issue

Vol. 31 (2026)

Section

Original Articles

License

Copyright (c) 2026 Karine Raquel Uhdich Kleibert, Alana Thais Gisch Andres, Lenara Schalanski Krause, Viviane Fereira de Melo, Adriane Cristina Bernat Kolankiewicz, Mariana Rodriges Botton, Christiane de Fátima Colet

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Cogitare Enfermagem reserves the right to make normative, orthographic, and grammatical changes to the published article to maintain the cultured standard of the language, while respecting the authors' style.

The published study is the sole responsibility of the author(s), and Cogitare Enfermagem is exclusively responsible for evaluating the manuscript as a scientific publication vehicle. Revista Cogitare Enfermagem is not responsible for any violations of Law No. 9,610/1998, the Brazilian Copyright Law.

Cogitare Enfermagem allows the author to hold the copyright of articles accepted for publication, without restrictions.

The articles published are licensed under the Creative Commons license CC BY 4.0 Creative Commons - Attribution 4.0 International - CC BY 4.0 - The attribution adopted by Cogitare Enfermagem is permitted:

  • Share - copy and redistribute the material in any media or format.
  • Adapt - remix, transform and build upon the material for any purpose, even commercially.
  • Attribution - You must give proper credit, provide a link to the license, and indicate if changes have been made. You may do this in any reasonable way, but not in a way that suggests that the licensor endorses it or approves of its use.
  • No additional restrictions - You may not apply legal terms or technological measures that legally restrict others from doing something that the license allows.