Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-17T03:21:47.672Z Has data issue: false hasContentIssue false
  • English
  • Français

Antiepileptic drugs in schizophrenia: a review

Published online by Cambridge University Press:  16 April 2020

L. Hosák  and
J. Libiger
L. Hosák*
Affiliation:
Department of Psychiatry, Charles University School of Medicine, 50005Hradec Králové, Czech Republic
J. Libiger
Affiliation:
Department of Psychiatry, Charles University School of Medicine, 50005Hradec Králové, Czech Republic
*
*Present address: Department of Psychiatry, University Hospital, 50005 Hradec Králové, Czech Republic. E-mail address:[email protected] (L. Hosák).
Get access

Summary

The first choice group of psychotropic agents in schizophrenia is neuroleptics. However, this treatment is not effective in all patients and with every symptom. We summarize papers published on the role of antiepileptic drugs in treatment-resistant schizophrenia. We have searched the computer database system MEDLINE for relevant articles including reviews, reports of drug studies and case histories. Antiepileptic drugs can change symptoms of schizophrenia by their action on GABA-ergic neurotransmission or via anti-glutamatergic mechanisms. High doses of adjunctive benzodiazepines reduce positive symptoms, anxiety, and agitation. Carbamazepine is effective in affective symptoms of schizophrenia and influences violent behavior in psychotic patients. Its anti-kindling action may represent a promising treatment strategy for some patients with chronic course of schizophrenia. Valproate treatment leads to a decrease in positive symptoms as well as hostility. Lamotrigine is expected to influence the positive, negative, affective, and cognitive symptoms of schizophrenia. New antiepileptics (e.g., gabapentin, oxcarbazepine, topiramate, vigabatrin) present a promise as potential adjuncts to neuroleptic treatment in resistant symptoms of schizophrenia.

Keywords

SchizophreniaAntiepileptic drugsGamma-aminobutyric acidGlutamate
Type
Review
Information
European Psychiatry , Volume 17 , Issue 7 , November 2002 , pp. 371 - 378
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anand, A.Charney, D.S.Oren, D.A.Berman, R.M.Hu, X.S.Cappiello, A.et alAttenuation of the neuropsychiatric effects of ketamine with lamotrigine. Arch Gen Psychiatr 2000;57:270–276.CrossRefGoogle ScholarPubMed
Brewerton, T.D.The phenomenology of psychosis associated with complex partial seizure disorder. Ann Clin Psychiatr 1997;9:31–51.CrossRefGoogle ScholarPubMed
Citrome, L.Levine, J.Allingham, B.Utilization of valproate: extent of inpatient use in the New York state office of mental health. Psychiatr Quarterly 1998;69:283–300.CrossRefGoogle ScholarPubMed
Davis, K.L.Kahn, R.S.Ko, G.Davidson, M.Dopamine in schizophrenia: a review and reconceptualization. Am J Psychiatr 1991;148:1474–1486.Google ScholarPubMed
Davis, L.L.Ryan, W.Adinoff, B.Petty, F.Comprehensive review of the psychiatric uses of valproate. J Clin Psychopharmacol 2000;20(Suppl 1):1S–17S.CrossRefGoogle ScholarPubMed
Deutsch, S.I.Mastropaolo, J.Schwartz, B.L.Rosse, R.B.Morihisa, J.M.A “glutamatergic hypothesis” of Schizophrenia. Rationale for Pharmacotherapy with Glycine. Clin Neuropharmacol 1989;12:1–13.CrossRefGoogle ScholarPubMed
Dose, M.Hellweg, R.Yassouridis, A.Theison, M.Emrich, H.M.Combined treatment of schizophrenic psychoses with haloperidol and valproate. Pharmacopsychiatry 1998;31:122–125.CrossRefGoogle ScholarPubMed
Dursun, S.M.McIntosh, D.Clozapine plus lamotrigine in treatment-resistant schizophrenia. Arch Gen Psychiatr 1999;56:950CrossRefGoogle ScholarPubMed
Elko, C.J.Burgess, J.L.Robertson, W.O.Zolpidem-associated hallucinations and serotonin reuptake inhibition: a possible interaction. J Toxicol Clin Toxicol 1998;36:195–203.CrossRefGoogle ScholarPubMed
Facciola, G.Avenoso, A.Scordo, M.G.Madia, A.G.Ventimiglia, A.Perucca, E.et alSmall effects of valproic acid on the plasma concentrations of clozapine and its major metabolites in patients with schizophrenic or affective disorders. Ther Drug Monitoring 1999;21:341–345.CrossRefGoogle ScholarPubMed
Fisher, R.Blum, D.Clobazam, oxcarbazepine, tiagabine, topiramate, and other new antiepileptic drugs. Epilepsia 1995;36(Suppl 2):S105–114.CrossRefGoogle ScholarPubMed
Galletly, C.A.Tsourtos, G.Antipsychotic drug doses and adjunctive drugs in the outpatient treatment of schizophrenia. Ann Clin Psychiatr 1997;9:77–80.CrossRefGoogle ScholarPubMed
Gündürewa, M.Beckmann, H.Zimmer, R.Rüther, E.Wirkung von valproinsäure auf schizophrene syndrome. Arzneim Forsch 1980;30:1212–1213.Google Scholar
Gutiérrez, K.Walter, H.Bankier, B.Valproic acid and carbamazepine: a successful antipsychotic medication? The problem of diagnosis and its relevance for therapy. Psychopathology 1999;32:235–241.CrossRefGoogle ScholarPubMed
Hesslinger, B.Klose, P.Normann, C.Langosch, J.M.Berger, M.Walden, J.Zur adjuvanten Behandlung schizophrener Störungen mit Carbamazepin. Fortschr Neurol Psychiat 1998;66:145–150.CrossRefGoogle Scholar
Hollister, L.E.Müller-Oerlinghausen, B.Rickels, K.Shader, R.I.Clinical uses of benzodiazepines. J Clin Psychopharmacol 1993;13(Suppl 1):72S–81S.CrossRefGoogle ScholarPubMed
Jibson, M.D.Tandon, R.New atypical antipsychotic medications. J Psychiatr Res 1998;32:215–228.CrossRefGoogle ScholarPubMed
Kerwin, R.W.Patel, S.Meldrum, B.S.Czudek, C.Reynolds, G.P.Asymmetrical loss of glutamate receptor subtype in left hippocampus in schizophrenia. Lancet 1988;1 8585:583–584.CrossRefGoogle Scholar
Kim, J.S.Kornhuber, H.H.Holzmüller, B.Schmid-Burgk, W.Mergner, T.Krzepinski, G.Reduction of cerebrospinal fluid glutamic acid in huntington's chorea and in schizophrenic patients. Arch Psych Nervenkrankheiten 1980;228:7–10.CrossRefGoogle ScholarPubMed
Koran, L.M.Gamma-aminobutyric-acid deficiency in schizophrenia. Lancet 1976;2(7993):1025CrossRefGoogle Scholar
Krystal, J.H.Karper, L.P.Seibyl, J.P.Freeman, G.K.Delaney, R.Bremner, J.D.et alSubanesthetic effects of the noncompetitive NMDA antagonist, ketamine, in humans. Arch Gen Psychiatr 1994;51:199–214.CrossRefGoogle Scholar
Lewohl, J.M.Crane, D.I.Dodd, P.R.Zolpidem binding sites on the GABA(A) receptor in brain from human cirrhotic and non-cirrhotic alcoholics. Eur J Pharmacol 1997;326:265–272.CrossRefGoogle ScholarPubMed
Macdonald, R.L.Kelly, K.M.Antiepileptic drug mechanisms of action. Epilepsia 1995;36(Suppl 2):S2–12.CrossRefGoogle ScholarPubMed
Markowitz, J.S.Brewerton, T.D.Zolpidem-induced psychosis. Ann Clin Psychiatr 1996;8:89–91.CrossRefGoogle ScholarPubMed
Meltzer, H.Y.Goode, D.J.Fang, V.S.Schyve, P.Young, M.Dopamine and schizophrenia. Lancet 1976;2:(7995)1142CrossRefGoogle Scholar
Messenheimer, J.A.Lamotrigine. Epilepsia 1995;36(Suppl 2):S87–94.CrossRefGoogle ScholarPubMed
Messenheimer, J.Mullens, E.L.Giorgi, L.Young, F.Safety review of adult clinical trial experience with lamotrigine. Drug Safety 1998;18:281–296.CrossRefGoogle ScholarPubMed
Morinigo, A.Martin, J.Gonzalez, S.Mateo, I.Treatment of resistant schizophrenia with valproate and neuroleptic drugs. Hill J Clin Psychiatr 1989;11:199–207.Google ScholarPubMed
Nachshoni, T.Levin, Y.Levy, A.Kritz, A.Neumann, M.A double-blind trial of carbamazepine in negative symptom schizophrenia. Biol. Psychiatr 1994;35:22–26.CrossRefGoogle ScholarPubMed
Nelson, J.C.Combined treatment strategies in psychiatry. J Clin Psychiatr 1993;54(Suppl 9):42–49.Google Scholar
Okuma, T.Yamashita, I.Takahashi, R.Itoh, H.Otsuki, S.Watanabe, S.et alA double-blind study of adjunctive carbamazepine versus placebo on excited states of schizophrenic and schizoaffective disorders. Acta Psychiatr Scand 1989;80:250–259.CrossRefGoogle ScholarPubMed
Olney, J.W.Farber, N.B.Efficacy of clozapine compared with other antipsychotics in preventing NMDA-antagonist neurotoxicity. J Clin Psychiatr 1994;55(Suppl B):43–46.Google ScholarPubMed
Olney, J.W.Farber, N.B.Glutamate receptor dysfunction and schizophrenia. Arch Gen Psychiatr 1995;52:998–1007.CrossRefGoogle Scholar
Olney, J.W.Labruyere, J.Wang, G.Wozniak, D.F.Price, M.T.Sesma, M.A.NMDA antagonist neurotoxicity: mechanism and prevention. Science 1991;254:1515–1518.CrossRefGoogle ScholarPubMed
Post, R.M.Comparative pharmacology of bipolar disorder and schizophrenia. Schizophr Res 1999;39:153–158.CrossRefGoogle Scholar
Richardson-Burns, S.M.Haroutunian, V.Davis, K.L.Watson, S.J.Meador-Woodruff, J.H.Metabotropic glutamate receptor mRNA expression in the schizophrenic thalamus. Biol. Psychiatr 2000;47:22–28.CrossRefGoogle ScholarPubMed
Simhandl, C.Meszaros, K.The use of carbamazepine in the treatment of schizophrenic and schizoaffective psychoses: a review. J Psychiatr Neurosci 1992;17:1–14.Google ScholarPubMed
Simhandl, C.Meszaros, K.Denk, E.Thau, K.Topitz, A.Adjunctive carbamazepine or lithium carbonate in therapy-resistant chronic schizophrenia. Can J Psychiatr 1996;41:317CrossRefGoogle ScholarPubMed
Siow-Ann, C.Chay-Hoon, T.Ee-Lian, L.Pei-Hsiang, L.Augmentation of risperidone with valproic acid. J Clin Psychiatr 1998;59:430Google Scholar
Smith, M.E.A clinical study of chlorpromazine and chlordiazepoxide. Conn M 1961;25:153–157.Google Scholar
Wassef, A.A.Dott, S.G.Harris, A.Brown, A.O'Boyle, M.Meyer, W.J.et alCritical review of GABA-ergic drugs in the treatment of schizophrenia. J Clin Psychopharmacol 1999;19:222–232.CrossRefGoogle ScholarPubMed
Wassef, A.Watson, D.J.Morrison, P.Bryant, S.Flack, J.Neuroleptic-valproic acid combination in treatment of psychotic symptoms: a three-case report. J Clin Psychopharmacol 1989;9:45–48.CrossRefGoogle ScholarPubMed
Wolkowitz, O.M.Pickar, D.Benzodiazepines in the treatment of schizophrenia: a review and reappraisal. Am J Psychiatr 1991;148:714–726.Google ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.