Carbamazepine is useful in treating many kinds of seizures that occur in children. But other types can be exacerbated (see Contraindications), so a correct diagnosis is critical.

Children metabolize and eliminate carbamazepine faster than adults do. Consequently they require higher doses relative to their weight. Their blood levels may fluctuate widely, so they often are more affected by dose-related side effects and may need to take smaller, more frequent doses. These differences diminish by the early to mid teens.

Using an extended-release form like Tegretol-XR or Carbatrol may reduce the problems caused by wide swings in blood level. Because Tegretol-XR tablets must be swallowed whole, however, it is seldom used by small children. (Carbatrol capsules, on the other hand, can be opened and the contents sprinkled over a spoonful of food without affecting its extended-release properties.)

The initial dosage for children is generally 5-10 mg/kg, divided into two daily doses. Increases usually go no higher than 35 mg/kg. Very young children tend to require higher dosages relative to weight than older children.