Oxcarbazepine, another off label medication frequently used in the treatment of bipolar disorder, has much in common with carbamazepine. Its side effect profile, however, is more favorable, and it is not associated with causing a drop in the white blood cell count (agranulocytosis). This is a medication that is receiving significant attention among researchers and practitioners, largely because of the hope that it has the efficacy of carbamazepine, but with a more tolerable side effect profile.
Oxcarbazepine is metabolized in the liver and has an active metabolite (a breakdown product also believed to have efficacy). Between the parent compound and the metabolite, the half-life is roughly nineteen hours.
As with carbamazepine, the risk of unplanned pregnancy for women on oral contraceptives is increased, and an alternative form of birth control would be recommended.