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Trileptal Withdrawal Symptoms, Side Effects, Treatment Help

Last Updated on January 24, 2024 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

Trileptal withdrawal should be gradual according to the FDA.1,6 Rebound symptoms such as the return of seizures may be much less likely when oxcarbazepine withdrawal is managed carefully and precisely.

Trileptal (also available as an extended-release medication) can cause impaired cognitive functions. Consequences such as forgetting a dose, or other lapses, suggest that one would be wise to enlist help should one decide to quit taking Trileptal. Thousands of clients at Alternative to Meds Center have successfully completed medication withdrawal successfully in a comfortable and relaxed setting, with the advantage of alternative treatments to ease medication withdrawal symptoms.

Do Your Symptoms Require Trileptal?
trileptal withdrawal
Alternative to Meds Center has been focused on medication withdrawal, for nearly 2 decades. Our published evidence clearly demonstrates the success of our clients. Many ATMC staff have personally experienced coming off Trileptal and similar drugs in a safe and gentle manner. This is why we feel genuinely called to assist others. We have found that each person needs individualized support. Testing reveals some people are neurotoxic, assessments help demonstrate that others need lifestyle changes, and dietary and supplementation programs are broadly used. Possibly genetic factors may act as contributors, as well as other medical conditions that can be identified and assisted.
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What Is Trileptal Used For?

Trileptal has FDA approval for the reduction of partial seizures.2,3,6 Partial seizures affect only one area of the brain, most usually the temporal lobes located behind the ears. When a seizure or partial seizure occurs, a jolt of electricity fires from one part of the brain to another part. The vast majority of partial seizures are harmless but sometimes can be more severe. A single episode of a partial seizure carries a low risk of recurrence. trileptal seizuresWhere 2 or more seizures occur more than 24 hours apart, the condition may be diagnosed as epilepsy. Sometimes a partial seizure is preceded by an “aura,” which presents as unusual perception changes, that may signal that a seizure is going to occur. An aura can occur without being followed by a seizure. Examples of how an aura feels may include weakness, warmth, lightheadedness, nausea, or headache. Black spots or changes to vision may occur, or one may hear buzzing sounds or voices or other unusual aural perceptions. Emotions may suddenly present such as panic, dread, detachment, or joy. Sensory changes like a bad taste or an odd smell are also commonly reported during an aura.12,13

Doctors may prescribe Trileptal to children as young as two years of age. After childbirth, women are advised not to breastfeed as the drug will be passed to the infant directly. Birth defects such as oral clefts and cardiac malformations have not been definitively established through clinical studies, but are thought likely associated with Trileptal, as these adverse effects have been reported in pregnancy registries according to the drug label, as well as the National Institute of Health. These concerns are underscored due to evidence that Trileptal reduces the effectiveness of oral contraceptives for women hoping to avoid pregnancy if they are prescribed Trileptal.1,6,21

Although Trileptal or the generic oxcarbazepine was initially used for treating partial seizures in epileptic patients, a number of “off-label” uses have developed for the drug including schizoaffective disorders and reducing mania in bipolar conditions.2

The drugmaker Novartis® was sued in 2010 for $422.5 million for promoting Trileptal for neuropathic pain management, which the drug was never FDA-approved to treat.11

The exact mechanisms of action of Trileptal are not fully known. Clinical research involving electro-shocking mouse brain tissues suggested that the drug may block sodium channels, causing a protective effect against an electrical charge. It has also been suggested that Trileptal, like other AEDs, may possibly be GABAergic in their effects, but more research is needed to determine the exact mechanics involved.9,14

Severe Adverse Effects that May Require Trileptal Withdrawal

Due to some extreme side effects of Trileptal, as well as concerns of potential pregnancy risks, a person may consider stopping Trileptal. The FDA drug label 3,6 warns of adverse reactions that were statistically significant in placebo-controlled trials. Some examples follow:

  • trileptal serious adverse risksTrileptal significantly increased the risk of suicidal ideation and behavior during clinical trials.
  • Trileptal showed a nearly 2X rate of impaired cognitive and motor functions over placebo, making it risky to drive or operate machinery.
  • “DRESS,” (Drug Reaction with Eosinophilia and Systemic Symptoms) can cause fatal or life-threatening reactions including fever, rash, enlarged lymph nodes, facial swelling, liver dysfunction, kidney inflammation, blood abnormalities, inflamed heart muscle, or other tissues.
  • Increased risk of Stevens-Johnson syndrome, a potentially life-threatening condition
  • Seizure aggravation
  • Hyponatremia (low blood sodium)
  • Eosinophilia (abnormally high white blood cell count)
  • Leukopenia (abnormally low white blood cell count)
  • Double vision, nystagmus (jerking or rolling rhythmic eye movements) other vision abnormalities
  • Headache
  • Nausea, vomiting
  • Tremors, abnormal gait, dizziness
  • Somnolence, fatigue
  • Ataxia (a neurodegenerative condition involving muscles, coordination, speech, a person may appear drunk) is also caused by B12 deficiency, head injury, radiation poisoning and other causes.15

Despite the above adverse effects connected with taking Trileptal, there are no FDA black box warnings on the drug packaging. Never abruptly stop taking Trileptal and don’t try to do it on your own. Always seek help and support before attempting to withdraw from Trileptal. If severe adverse effects present, such as DRESS, Stevens-Johnson Syndrome, or others on the above list, a physician or clinician may need to reduce the drug more rapidly or even immediately, due to the risk of fatality that continuing the medication might present. Abruptly stopping Trileptal could only be done safely in a clinical/medical or ICU setting where emergency treatment is on hand to help ensure the person survives.6,21

Trileptal Withdrawal Symptoms

The drug label suggests that where Trileptal is discontinued, the process should be gradual to lessen the severity of Trileptal withdrawal symptoms, though there is a lack of adequate research and specific guidelines on AED (anti-epileptic medication) withdrawal. A small clinical study10 found that Trileptal withdrawal may not be as likely to induce rebound symptoms as are some other AED medications. Some research recommends weeks to months for a gradual, safe cessation. It is known that sudden Trileptal withdrawal can induce seizures or relapse in a bipolar patient.21

Trileptal withdrawal symptoms can include:
  • A rebound of original mania for which the drug was prescribed
  • Increased severity or frequency of seizures
  • Anxiety
  • Panic
  • Restlessness
  • Sweating

Natural Alternatives to AEDs (Anti-Epileptic Drugs)

Because the drug is known to induce relaxation and emotional dulling, it is possible that a doctor prescribed it off-label as an antidepressant or mood stabilizer, for example, to treat manic episodes, though it is not licensed specifically for that purpose. According to studies, there are non-pharmacological treatments discussed below for improved mental health that have shown promising efficacy.20

natural alternatives to anti-epileptic drugsWe provide educational steps in our mental health treatment plans to acquaint our clients with alternative treatments to ease withdrawal from medications and reduce symptoms for which drugs were prescribed. We seek to further investigate root causes for symptoms before electing medication as the sole solution for symptoms a person is experiencing. There are many of these types of drug-free therapies that our clients learn about in our educational component.4,5

Lab testing opens the door to previously missed indicators of unwanted conditions and symptoms. In the rush to find relief, we find that many of our clients were never offered earnest investigative testing before coming to Alternative to Meds Center for help. Nutritional, environmental, biophysical, and other factors can play a role in health matters, including mental health. In most cases, none received guidance or education on such factors that, if addressed, could have positively impacted their health.

Alternative treatments successfully treat many symptoms without drugs. According to the work of Gwathmey and Grogan published in the 2020 Journal of Muscle and Nerve, neuropathies respond to correcting nutritional deficiencies, nutrient loss, and malabsorption.17 Depressive symptoms can be successfully treated with many forms of nonpharmacological solutions. For example, a 2016 clinical study of 20,000 participants, authored by Farah et al and published in the Journal of Evidence-Based Medicine found that nonpharmaceutical treatments such as cognitive behavioral therapy, physical activity, and naturopathic treatments reduced the severity of depression symptoms without the adverse side effects associated with antidepressants.16,18

Toxic exposure has been a growing concern in the health field as it is becoming more common as time goes on. A study on children assessed household, school, and occupational exposures to pesticides and insecticides used in the home, in the yard, and at schools. The researchers found that such chemicals were associated with poorer neural and mental development, as well as leukemia, brain tumors, inattention, and other significant health consequences.19 Clearing out accumulated toxins is an alternative health measure that many find beneficial. At Alternative to Meds, neurotoxin removal is one of the fundamentals of health recovery, often leading to the reduction or elimination of symptoms due to neurotransmitter rehabilitation.

Find Out More About the Alternative to Meds Center

expert tapering & withdrawal helpWhether your doctor prescribed Trileptal for the treatment of partial seizures, depression, bipolar, pain management, or for any other reason, Alternative to Meds Center is here to help our clients find the best path to their physical and mental health goals. We specialize in holistic, medically supervised protocols and treatment for drug withdrawal. We provide a wealth of adjunct therapies that are designed to make withdrawal easier and more pleasant.

Often, doctors will prescribe multiple drugs along with Trileptal. Tapering from more than one medication can seem like a daunting task, nearly impossible to untangle. We have the science-based technology and a staff of over 40 licensed professionals to assist you each step of the way.

Call us today for more information on our protocols, treatment timelines, insurance coverage, and any other questions you may have. Our center may be able to offer you the treatment you have been seeking. You are not alone. Find out how Alternative to Meds Center can help you or a loved one to successfully overcome the often complex challenges of Trileptal withdrawal.


1. Moigaard-Nielsen D, Newer-generation antiepileptic drugs and the risk of major birth defects, JAMA 2011 May [INTERNET] [cited 2022 Aug 30]

2. Oxcarbazepine Information Letter NAMI [published online 2019] [cited 2022 Aug 30]

3. FDA Information Sheet Trileptal/oxcarbazepine [cited 2022 Aug 30]

4. Penckofer S, Kouba J, Byrne M, Estwing Ferrans C, “Vitamin D and Depression – Where is all the Sunshine?” Issues Ment Health Nurs June 2010 [INTERNET] [cited 2022 Aug 30]

5. Scaccia A, Legg T J, “Is a Vitamin D Deficiency Causing Your Depression?” Healthline [Internet] 2017 Mar 21[cited 2022 Aug 30]

6. FDA drug label Trileptal Approved 2000 [internet] [cited 2022 Aug 30]

7. Information letter Epilepsy Society, “Coming off Treatment.” published [online] Sept 18 2018 [cited 2022 Aug 30]

8. Hixson JD. Stopping antiepileptic drugs: when and why?Curr Treat Options Neurol. 2010;12(5):434-442. doi:10.1007/s11940-010-0083-8 [cited 2022 Aug 30]

9. Emrich HM, Altmann H, Dose M, von Zerssen D. Therapeutic effects of GABA-ergic drugs in affective disorders. A preliminary report. Pharmacol Biochem Behav. 1983 Aug;19(2):369-72. doi: 10.1016/0091-3057(83)90067-9. PMID: 6415677. [cited 2022 Aug 30]

10. Macritchie KA, Hunt NJ. Does ‘rebound mania’ occur after stopping carbamazepine? A pilot study. J Psychopharmacol. 2000;14(3):266-8. doi: 10.1177/026988110001400312. PMID: 11106306. [cited 2022 Aug 30]

11. Petrochko C., Medpage Today author. “Novartis Settles Civil and Criminal Cases for $422.5 million.” [online] Oct 1 2010 [cited 2022 Aug 30]

12. Patel PR, De Jesus O. Partial Epilepsy. [Updated 2021 Feb 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: [cited 2022 Aug 30]

13. Epilepsy Foundation Community Forum, “How Exactly do Auras Feel?” [online] [cited 2022 Aug 30]

14. McLean MJ, Schmutz M, Wamil AW, Olpe HR, Portet C, Feldmann KF. Oxcarbazepine: mechanisms of action. Epilepsia. 1994;35 Suppl 3:S5-9. doi: 10.1111/j.1528-1157.1994.tb05949.x. PMID: 8156978. [cited 2021 Aug 30]

15. Hafiz S, De Jesus O. Ataxia. [Updated 2021 Aug 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: [cited 2022 Aug 27]

16. Farah WH, Alsawas M, Mainou M, Alahdab F, Farah MH, Ahmed AT, Mohamed EA, Almasri J, Gionfriddo MR, Castaneda-Guarderas A, Mohammed K, Wang Z, Asi N, Sawchuk CN, Williams MD, Prokop LJ, Murad MH, LeBlanc A. Non-pharmacological treatment of depression: a systematic review and evidence map. Evid Based Med. 2016 Dec;21(6):214-221. doi: 10.1136/ebmed-2016-110522. Epub 2016 Nov 11. PMID: 27836921. [cited 2022 Aug 30]

17. Gwathmey KG, Grogan J. Nutritional neuropathies. Muscle Nerve. 2020 Jul;62(1):13-29. doi: 10.1002/mus.26783. Epub 2019 Dec 26. PMID: 31837157. [cited 2022 Aug 30]

18. Meister K, Becker S. Yoga bei psychischen Störungen [Yoga for mental disorders]. Nervenarzt. 2018 Sep;89(9):994-998. German. doi: 10.1007/s00115-018-0537-x. PMID: 29858642. [cited 2022 Aug 30]

19. Roberts JR, Karr CJ; Council On Environmental Health. Pesticide exposure in children. Pediatrics. 2012 Dec;130(6):e1765-88. doi: 10.1542/peds.2012-2758. Epub 2012 Nov 26. Erratum in: Pediatrics. 2013 May;131(5):1013-4. PMID: 23184105; PMCID: PMC5813803. [2022 Aug 30]

20. Crowe M, Porter R. Inpatient treatment for mania: A review and rationale for adjunctive interventions. Aust N Z J Psychiatry. 2014 Aug;48(8):716-21. doi: 10.1177/0004867414540754. Epub 2014 Jun 25. PMID: 24965582. [cited 2022 Aug 30]

21. Preuss CV, Randhawa G, Wy TJP, et al. Oxcarbazepine. [Updated 2022 May 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: [cited 2022 Aug 30]

Originally Published Sep 19, 2018 by Diane Ridaeus

This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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Medical Disclaimer:
Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.

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