Chronic, not acute treatment with carbamazepine enhanced the hypothermic response to a dose of clonidine thought to exert its predominant effect on the presynaptic alpha 2-autoreceptor. This response was markedly elevated both during the course of and 10 days after the discontinuation of treatment with carbamazepine. Sensitivity to clonidine returned to baseline 10 to 21 days after the discontinuation of treatment. Carbamazepine is the first treatment for the disorders of mood that has been demonstrated to enhance a physiological response to clonidine. The authors discuss the theoretical relationship between increased sensitivity of the presynaptic alpha 2-autoreceptor and the usefulness of carbamazepine in the treatment of bipolar disorder.
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