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Difference between Tegratol and Carbamazepine

Hello All,
I have been taking Tegratol for about 15-18 years now. Do to my health insurance i have to pay full price for Tegratol or get Carbamazepine for $25.00. My question is, Is there any difference between these two medication? The Tegratol has been working great for me and I hate to change. But $250.00 for 90 versus $25.00 for 90. Has anyone out there taken Tegratol and switched to Carbamazepine and not have any trouble.
Thanks you for your time.


I am a Tegretol taker for different reasons.  Theoretically I am "Bipolar2", although many of my behaviors can also be attributed to my Aspergers.  I have also had one epileptic seizure while in high school, which went unreported on the advice of an epileptic friend who wasn't any more mature about such things than I was.

I say all this as context on my experience with being given Carbamezapine instead of Tegretol.  After being prescribed Tegretol, and once we got the dose right, I was in extremely good control.  After 12 years came the unexpected switch to Carbamezapine.  The first three days on Carb. were a roller coaster of rage, frustration, deep depression, and fright -- fright because I was clearly completely out of control and didn't know why.  After that came three weeks of extremely disrupted sleep cycles, mood swings mostly from slight depression to deep depression (which is how I was before meds), a return to paranoia, and an inability to focus on anything I should have been doing. 

Then I talked to my psychiatrist, who said that she hears about mood disruptions from all of her patients who are switched to Carb. by their insurance.  The experiences are not always the same, but they tend to be similar and, well, disruptive.

It's possible that you epileptics are reporting less of a difference between the two because the differences between the two only affect those of us with mood disorders??  I have no what really explains why so many of you report little difference, but I wanted there to be some indication here that not all Tegretol users experience no difference between Tegretol and Carbamezapine. 

The return to Tegretol hasn't been instantaneous, but I'm still getting back to "normal" and very happy that I have enough money to afford the difference.  It's not as if I'm rich, I will have to give up a little more to afford this every month, but having stable moods is worth every penny.

If you have to switch to the generic, ask your pharmacist to make a note to only use the same manufacturer.  Sometimes when you use a generic, there are more than one manuf. out there, and, obviously, the pills are not made exactly the same, which can cause some problems, esp. if you've been taking the brand name for years.  A good pharmacist will be happy to comply.  I wish you the best luck in the switch.


I was on tegretal for 23+ years. I was always told not to switch from a brand to a generic brand. Sometimes they are made a bit different. You could have a reaction from it and cause a seizure.
I was always put on a brand name.

take care

Tegratol is carbamazepine. carbamazepine is the generic, actual drug name. Tegratol and Carbatrol are both brand names of carbamazepine. I don't see why you would experience a big difference between the two. I'm on Carbatrol and only have to take it 2 times a day, but i know people who are on Tegratol who have to take it more often during the day. To my knowledge, thats the only difference, the way it is dosed due to the different brands. :)

I have taken Tegratol for years. At one point, I did switch to Carb. until my insurance would pay for the other. One thing that made that difference was that I switched to the XR version of Tegtatol. There is no generic for that so my insurance had to cover it.

Anyway, I had no problems with th switch. I would, of course, talk to your doc first (or at least his nurse).

Hope everything works out for you.

I realize that medication can affect us all diferently, but I did try the carb. instead of the name brand Tegretol. It did not work for me at all. My neuro had advised me to always go name brand on both of my seizure medications (Depakote and taking Tegretol XR instead of the Tegretol). It may be an individual reaction but my advice after my experience is to stick to the name brand. Good luck!


Tegretol is the brand name of carbarmazepine. While they are essentailly the same drug, differences can occur in how much actually gets into the system when comparing brand names to generic, one type of a generic to another, or short-acting to long-acting formulations. The problems arise when small fluctuations in drug levels cause large differences in side effects or seizure control. The differences have been documented pretty well with Dilantin and phenytoin (the generic). They occur with Tegretol and carbamazepine but have not been as well documented.

So what to do? Work with the prescribing doctor and the pharmacist to stay on the same formulation. The problem is that there can be more than one company making a generic formulation of a drug and if so, fluctuations between generics can occur! If someone takes brand Tegretol, try to get that consistently. If on a generic carbamazepine, try to get same generic carb at each refill. People need to work with their pharmacist on this as the pharmacist may just buy whatever is the cheapest each month!

If people are noticing changes in the drug levels and breakthrough seizures, sometimes trying a longer-acting version of a drug may keep more constant amounts in the body and less breakthrough seizures.

Here are some links to info that talks about carbamazepine and/or generics to get you started. When keeping seizure diaries, it's helpful to note when you get meds refilled and if any changes in the drug(s) and share the info with the doctor!

Hope this helps, Resource Specialist

Thank you all for your comments. I'm still trying to get the insurance company to let me get tegretol as a forumal drug ($75.00 vs $250.00). Still is there any know out there that made the change after many years on tegretol and what was your out come?
Thanks again.

Hi matta25.

I wish I could help out here with your search for an outcome. All I can add is I once read that in the U.S, Carbatrol  may be superior to Tegretol XR. The manufacturer emphasizes smoother blood levels over time (less "peaks and troughs".) which helps.

I know over time I have taken tegretol, gained good control, and thank the Lord for that. I have a few joint problems that could be a side effect of tegretol, but I cope, no big deal or major issue. I can drive again, I have a life again. I'm avoiding surgery as long as I can, and taking the vitamins along with a calcium supplement.

Hang in there, stay upbeat and positive.


Toni Munson
I had your same problem. For years I took Carbamazepine because I couldn't afford the Tegretol. I was told there was no difference, then I had a neurologist say it was better to take Tegretol. I was having a lot of break through seizures while on the carbamazepine and they were getting worse. Finally I got insurance and the Neurologist put me on Carbatrol XR. My Seizures are mostly controlled until 1 week in the month. Then I have break through seizures but they are only 30 seconds. I like Carbatrol a lot better. I think Tegretol and Carbatrol are better to take then the carbamazepine.

I have been on Tegretol for 22 years, and occasionally have had to take Carbamezapine due to health insurance reasons, or being sent Carbamezapine when non-generic was not specified. I had one neurologist that said absolutely not to take it. I am taking it right now because of my insurance, and have noticed no difference, except that pill melts easily and tastes awful. I certainly paid less for the Carbamezapine, that's for sure. My currnent doctor doesn't seem to think it's a problem.

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