Psychiatric Applications of the New Antiepileptic Drugs

Abstract

Antiepileptic drugs (AEDs) have a broad range of activity in the central nervous system and can thus be expected to have multiple clinical effects. Older AEDs have been used in psychiatry for some time. Introduction of the new AEDs within the last decade has been followed by reports of their efficacy in patients who had failed the more established treatment regimens. It has become evident that drugs such as gabapentin, lamotrigine, levetiracetam, oxcarbazepine, topiramate, zonisamide, and tiagabine have beneficial safety and cognitive profiles and appear to be well tolerated by patients. While there are an increasing amount of data available indicating that these drugs may be effective in treating certain aspects of anxiety disorders, depression, and bipolar disorder, still not enough is known about all of their potential uses. It is difficult for clinicians to evaluate and use these drugs in the absence of clinical trials. Until more studies are done to increase the evidence base for the effectiveness of these agents, we have to rely on observations from community practice and personal experiences in making treatment choices.