A review of carbamazepine and valproate use in a psychiatric hospital in Thailand

Objective: to review the clinical use of carbamazepine (cbz) and valproate (vpa) in a psychiatric hospital in thailand. design: retrospective medical record review. setting: an outpatient department of a psychiatric hospital in the central part of thailand. participants: patients prescribed either cbz or vpa in january 2005 and continued the medications for at least six months. results: there were 277 cases receiving either cbz or vpa during the study period, 57.8% were male. cbz was prescribed in 92 cases, vpa 185 cases. mood stabilizing was the most common indication. however, more than 50% were prescribed the medications for other offlicense indications. the doses were not slowly titrated. means of current dose were lower than the recommended doses. a small number of minor adverse drug reactions were found. weight gain was under recognized. conclusion: off-license uses of cbz and vpa were common. sub-therapeutic doses were frequently prescribed. the benefits of lower doses in this off-license use need an extensive evaluation. guidelines for the use of cbz and vpa in psychiatric patients may be useful for rational drug use program