Eslicarbazepine

An anticonvulsant related to oxcarbazepine, FDA-approved for partial-onset (focal) seizures in adults and children 4 years and older.

psilodex.org/m/eslicarbazepine · data v2026.10.05

Clinical contraindication: None listed; No label contraindication covering psilocybin was found. This is not a finding that the combination has been shown to be without risk.
Psilocybin evidence: No psilocybin data
Half-life: 13–20 h; Approximate, in adults. Source under Interaction below.

Named in state rules?

Not namedColorado Condition rules (3)

Not namedOregon

PendingNew Mexico

Cite asPsilodex, “Eslicarbazepine”, v2026.10.05. psilodex.org/m/eslicarbazepine

Clinical data and state rules are separate facts. Both are shown; neither is a decision.

What it is used for

FDA status

FDA-approved

FDA-approved for

Partial-onset (focal) seizures (age 4 and older)

Sources [1]

01 Interaction with psilocybin

It may lower psilocybin levels by speeding how the body clears psilocybin (untested). Stopping it suddenly after regular use can cause seizures.

Detail There are no psilocybin data. Its label states eslicarbazepine can induce (speed up) CYP3A4, one of the enzymes that broke down psilocin in lab studies. So psilocin levels may fall; this is untested. Separately, its label lists dizziness, sleepiness, low sodium and a raised risk of suicidal thoughts. Abrupt withdrawal can increase seizures. Sources [1][2]

Human data with psilocybin: No psilocybin data; based on how it works and its label
Half-life: 13–20 h (FDA label, checked 2026-10-04) Apparent half-life of the active form, eslicarbazepine, in adults with epilepsy.

Evidence types on this record

No psilocybin dataNo psilocybin data: no human data with psilocybin or another classic psychedelic; the text draws on the medication's own pharmacology and its label or reference facts

02 Pharmacology relevant to psilocybin

6 listed · counted on reports

Sedating or CNS depressant: Slows the central nervous system: drowsiness, slower reactions and impaired coordination, and slowed breathing at high doses. Effects add with other sedating substances. Sources [1]
Dehydration or electrolyte risk: Can cause dehydration or shifts in sodium or potassium. Sources [1]
Withdrawal or rebound if stopped abruptly: Stopping suddenly can cause withdrawal or a rebound of symptoms. Sources [1]
Speeds up drug metabolism: Increases the liver enzymes that break down many medicines, lowering their levels. When it is stopped, levels of other medicines can rise over the following weeks. Sources [1]
Liver injury: The label or source warns of liver injury, from raised liver enzymes to liver failure. Liver disease also affects how the body clears psilocin. Sources [1]
Psychiatric reactions: The label or source warns of psychiatric effects such as psychosis, mania, hallucinations, suicidal thoughts or severe mood or behavior changes. Psilocybin can also bring up strong emotions, so these warnings are relevant to screening. Sources [1]

03 State rules

Plain-language summary · official text governs

CO4 CCR 755-1

Not namedCondition rules (3)

No provision names this medication or its class.

Colorado · checked 2026-10-04

OROAR 333-333

Not named

No provision names this medication or its class.

Oregon · checked 2026-10-04

NM7.35.3 NMAC (proposed)

Pending

New Mexico's clinical rules (proposed 7.35.3 NMAC) are not final. No provision naming this medication has been found.

New Mexico · checked 2026-10-04

04 Conditions to ask about

Screening items in state rules

This medication is usually taken for a condition. State rules screen for some conditions directly, so the medication is a prompt to ask about them. Confirm with the participant; never assume a condition from the medication.

Seizure disorder (usual indication)
- CO 2.5(A)(2) · Clinical Facilitator licensees
- CO 6.16(F)(2)(a) · Facilitators without a clinical facilitator license
- CO 6.16(F)(1) · All licensees

05 Sources

APTIOM (eslicarbazepine acetate) tablet · FDA label (DailyMed) — Psychiatric reactions: 5.1 Suicidal Behavior and Ideation "Antiepileptic drugs (AEDs), including APTIOM, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication." | Dehydration or electrolyte risk: 5.5 Hyponatremia "Clinically significant hyponatremia (sodium <125 mEq/L) can develop in patients taking APTIOM." | Sedating or CNS depressant: 5.6 Neurological Adverse Reactions "APTIOM causes dose-dependent increases in somnolence and fatigue-related adverse reactions (fatigue, asthenia, malaise, hypersomnia, sedation, and lethargy)." | Withdrawal or rebound if stopped abruptly: 5.7 Withdrawal of AEDs "because of the risk of increased seizure frequency and status epilepticus" | Liver injury: 5.8 Drug Induced Liver Injury "Hepatic effects, ranging from mild to moderate elevations in transaminases (>3 times the upper limit of normal) to rare cases with concomitant elevations of total bilirubin (>2 times the upper limit of normal) have been reported with APTIOM use." | Speeds up drug metabolism: 7.3 CYP3A4 Substrates "In vivo studies suggest that APTIOM can induce CYP3A4, decreasing plasma concentrations of drugs that are metabolized by this isoenzyme (e.g., simvastatin, lovastatin)" | 12.3 Pharmacokinetics "The apparent half-life of eslicarbazepine in plasma was 13-20 hours in adult epilepsy patients."
Thomann J, Kolaczynska KE, Stoeckmann OV, et al. In vitro and in vivo metabolism of psilocybin’s active metabolite psilocin. Front Pharmacol 2024;15:1391689. — Lab studies: MAO-A, CYP2D6 and CYP3A4 metabolized psilocin; glucuronidation and conversion to 4-HIAA are the main routes.

Record history

v2026.10.02First published.
2026-10-04Last reviewed against its sources.

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