Carbamazepine is effective against partial seizures, secondarily generalized seizures, and tonic-clonic seizures. It is not effective against other generalized seizure types, such as absence seizures or myoclonic seizures.

Effective serum concentrations generally range from 4-12 mg/L, though lower or higher concentrations may be necessary in some individual patients. Serum concentrations should be checked after approximately one month of treatment, when autoinduction may occur.

A VA Cooperative study in adults with partial and generalized tonic-clonic seizures (Mattson et al. 1985) showed that CBZ was as effective as phenytoin and better tolerated than phenobarbital or primidone. Another VA study (Mattson et al. 1992) showed that CBZ was as effective as valproate for secondarily generalized seizures and more effective for partial seizures.

If carbamazepine alone does not stop all seizures, a combination of carbamazepine and another AED may be more effective. Phenytoin or Valproate are often used, but many newer AEDs are also available.