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Medicamentos antiepilépticos en la esquizofrenia: una revisión

Published online by Cambridge University Press:  12 May 2020

L. Hosák
Affiliation:
Departamento de Psiquiatría, Facultad de Medicina de la Universidad Carlos, 500 05Hradec Krátové, República Checa
J. Libiger
Affiliation:
Departamento de Psiquiatría, Facultad de Medicina de la Universidad Carlos, 500 05Hradec Krátové, República Checa
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Resumen

El primer grupo de elección de agentes psicotropos en la esquizofrenia son los neurolépticos. Sin embargo, este tratamiento no es efectivo en todos los pacientes y con todos los síntomas. Resumimos los artículos publicados sobre el papel de los medicamentos antiepilépticos en la esquizofrenia resistente al tratamiento. Hemos buscado el sistema informático de base de datos MEDLINE para artículos relacionados, incluidas las revisiones, los informes de estudios farmacológicos y las historias clínicas. Los medicamentos antiepilépticos pueden cambiar los síntomas de la esquizofrenia por su acción sobre la neurotransmisión GABA-érgica o por mecanismos anti-glutamatérgicos. Las dosis elevadas de benzodiacepinas complementarias reducen los síntomas positivos, la ansiedad y la agitación. La carbamacepina es eficaz en los síntomas afectivos de la esquizofrenia e influye en el comportamiento violento en los pacientes psicóticos. Su actuación acción anti-kindling puede representar una estrategia de tratamiento prometedora para algunos pacientes con curso crónico de esquizofrenia. El tratamiento con valproato lleva a una disminución en los síntomas positivos lo mismo que en la hostilidad. Se espera que la lamotrigina influya en los síntomas positivos, negativos, afectivos y cognitivos de la esquizofrenia. Los nuevos antiepilépticos (por ejemplo, gabapentina, oxcarbacepina, topiramato, vigabatrina) son prometedores como tratamiento complementario potencial al tratamiento neuroléptico en los síntomas resistentes de la esquizofrenia.

Type
Revisión
Copyright
Copyright © European Psychiatric Association 2003

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References

Bibliografía

Anand, A, Charney, DS, Oren, DA, Berman, RM, Hu, XS, Cappiello, A, et al.Attenuation of the neuropsychiatric effects of ketamine with lamotrigine. Arch Gen Psychiatr 2000;57:270-6.Google ScholarPubMed
Brewerton, TD.The phenomenology of psychosis associated with complex partial seizure disorder. Ann Clin Psychiatr 1997;9:3151.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;69:283300.CrossRefGoogle ScholarPubMed
Davis, KL, Kahn, RS, Ko, G, Davidson, M.Dopamine in schizophrenia: a review and reconceptualization. Am J Psychiatr 1991;148:1474-86.Google ScholarPubMed
Davis, LL, Ryan, W, Adinoff, B, Petty, F.Comprehensive review of the psychiatric uses of valproate. J Clin Psychopharmacol 2000;20(Suppl 1):1S17S.CrossRefGoogle ScholarPubMed
Deutsch, SI, Mastropaolo, J, Schwartz, BL, Rosse, RB, Morihisa, JM.A “glutamatergic hypothesis” of Schizophrenia. Rationale for Pharmacotherapy with Glycine. Clin Neuropharmacol 1989;12:113.CrossRefGoogle ScholarPubMed
Dose, M, Hellweg, R, Yassouridis, A, Theison, M, Emrich, HM.Combined treatment of schizophrenic psychoses with haloperidol and valproate. Pharmacopsychiatry 1998;31:122-5.CrossRefGoogle ScholarPubMed
Dursun, SM, Mclntosh, D.Clozapine plus lamotrigine in treatment-resistant schizophrenia. Arch Gen Psychiatr 1999;56:950.CrossRefGoogle ScholarPubMed
Elko, CJ, Burgess, JL, Robertson, WO.Zolpidem-associated hallucinations and serotonin reuptake inhibition: a possible interaction. J Toxicol Clin Toxicol 1998;36:195203.Google ScholarPubMed
Facciola, G, Avenoso, A, Scordo, MG, Madia, AG, Ventimiglia, A, Perucca, E, et al.Small effects of valproic acid on the plasma concentrations of clozapine and its major metabolites in patients with schizophrenic or affective disorders. Ther Dmg Monitoring 1999;21:341-5.Google ScholarPubMed
Fisher, R, Blum, D.Clobazam, oxcarbazepine, tiagabine, topiramate, and other new antiepileptic drugs. Epilepsia 1995;36(Suppl 2):S105114.CrossRefGoogle ScholarPubMed
Galletly, CA, Tsourtos, G.Antipsychotic drug doses and adjunctive drugs in the outpatient treatment of schizophrenia. Ann Clin Psychiatr 1997;9:7780.Google ScholarPubMed
Gündürewa, M, Beckmann, H, Zimmer, R, Rüther, E.Wirkung von valproinsáure auf schizophrene syndrome. Arzneim Forsch 1980;30:1212-3.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;32:235-41.Google ScholarPubMed
Hesslinger, B, Klose, P, Normann, C, Langosch, JM, Berger, M, Walden, J.Zur adjuvanten Behandlung schizophrener Stórun-gen mit Carbamazepin. Fortschr Neurol Psychiat 1998;66:145-50.CrossRefGoogle Scholar
Hollister, LE, Müller-Oerlinghausen, B, Rickels, K, Shader, RI.Clinical uses of benzodiazepines. J Clin Psychopharmacol 1993;13(Suppl 1):72S81S.CrossRefGoogle ScholarPubMed
Jibson, MD, Tandon, R.New atypical antipsychotic medications. J Psydiatr Res 1998;32:215-28.Google ScholarPubMed
Kerwin, RW, Patel, S, Meldrum, BS, Czudek, C, Reynolds, GP.Asymmetrical loss of glutamate receptor subtype in left hippocampus in schizophrenia. Lancet 1988;1(8585):583-4.CrossRefGoogle Scholar
Kim, JS, Kornhuber, HH, Holzmüller, B, Schmid-Burgk, W, Meigner, T, Krzepinski, G.Reduction of cerebrospinal fluid glutamic acid in huntington’s chorea and in schizophrenic patients. Arch Psych Nervenkrankheiten 1980;228:710.CrossRefGoogle ScholarPubMed
Koran, LM.Gamma-aminobutyric-acid deficiency in schizophrenia. Lancet 1976;2(7993):1025.CrossRefGoogle Scholar
Krystal, JH, Karper, LP, Seibyl, JP, Freeman, GK, Delaney, R, Bremner, JD, et al.Subanesthetic effects of the noncompetitive NMDA antagonist, ketamine, in humans. Arch Gen. Psychiatr 1994;51:199214.CrossRefGoogle Scholar
Lewohl, JM, Crane, DI, Dodd, PR.Zolpidem binding sites on the GABA(A) receptor in brain from human cirrhotic and non-cirrhotic alcoholics. Eur J Pharmacol 1997;326:265-72.CrossRefGoogle ScholarPubMed
Macdonald, RL, Kelly, KM.Antiepileptic drug mechanisms of action. Epilepsia 1995;36(Suppl 2):S212.Google ScholarPubMed
Markowitz, JS, Brewerton, TD.Zolpidem-induced psychosis. Ann Clin Psychiatr 1996;8:8991.CrossRefGoogle ScholarPubMed
Meltzer, HY, Goode, DJ, Fang, VS, Schyve, P, Young, M.Dopamine and schizophrenia. Lancet 1976;2(7995):1142.CrossRefGoogle Scholar
Messenheimer, JA.Lamotrigine. Epilepsia 1995;36(Suppl 2):S8794.CrossRefGoogle ScholarPubMed
Messenheimer, J, Mullens, EL, Giorgi, L, Young, F.Sa-fety review of adult clinical trial experience with lamotrigine. Drug Safety 1998;18:281-96.Google ScholarPubMed
Morinigo, A, Martin, J, Gonzalez, S, Mateo, I.Treatment of resistant schizophrenia with valproate and neuroleptic drugs. HiU J Clin Psychiatr 1989;11:199207.Google ScholarPubMed
Nachshoni, T, Levin, Y, Levy, A, Kritz, A, Neumann, M.A double-blind trial of carbamazepine in negative symptom schizophrenia. Biol. Psydiatr 1994;35:22-6.CrossRefGoogle ScholarPubMed
Nelson, JC.Combined treatment strategies in psychiatry. J Clin Psychiatr 1993;54(Suppl 9):42-9.Google Scholar
Okuma, T, Yamashita, I, Takahashi, R, Itoh, H, Otsuki, S, Watanabe, S, et al.A double-blind study of adjunctive carbamazepine versus placebo on excited states of schizophrenic and schizoaffective disorders. Acta Psychiatr Scand 1989;80:250-9.CrossRefGoogle ScholarPubMed
Olney, JW, Farber, NB.Efflcacy of clozapine compared with other antipsychotics in preventing NMDA-antagonist neurotoxicity. J Clin Psychiatr 1994;55(Suppl B):43-6.Google ScholarPubMed
Olney, JW, Farber, NB.Glutamate receptor dysfunction and schizophrenia. Arch Gen Psychiatr 1995;52:9981007.CrossRefGoogle Scholar
Olney, JW, Labruyere, J, Wang, G, Wozniak, DF, Price, MT, Sesma, MA.NMDA antagonist neurotoxicity: mechanism and prevention. Science 1991;254:1515-8.CrossRefGoogle ScholarPubMed
Post, RM.Comparative pharmacology of bipolar disorder and schizophrenia. Schizophr Res 1999;39:153-8.CrossRefGoogle Scholar
Richardson-Bums, SM, Haroutunian, V, Davis, KL, Watson, SJ, Meador-Woodruff, JH.Metabotropic glutamate receptor mRNA expression in the schizophrenic: thalamus. Biol. Psychiatr 2000;47:22-8.CrossRefGoogle Scholar
Simhandl, C, Meszaros, K.The use of carbamazepine in the treatment of schizophrenic and schizoaffective psychoses: a review. J Psychiatr Neurosa 1992;17:114.Google ScholarPubMed
Simhandl, C, Meszaros, K, Denk, E, Thau, K, Topitz, A.Adjunctive carbamazepine or lithiuan carbonate in therapy-iesistant chronic schizophrenia. Can J Psychiatr 1996;4l:317.CrossRefGoogle Scholar
Siow-Ann, C, Chay-Hoon, T, Ee-Lian, L, Pei-Hsiang, L.Augmentation of risperidone with valproic acid. J Clin Psychiatr 1998;59:430.Google Scholar
Smith, ME.A clinical study of chlorpnomazine and chlordiazepoxide. Conn Med 1961;25:153-7.Google Scholar
Wassef, AA, Dott, SG, Harris, A, Brown, A, O’Boyle, M, Meyer, WJet al.Critical review of GABA-ergic drugs in the treatment of schizophrenia. J Clin Psychopharmacol 1999;19:222-32.CrossRefGoogle ScholarPubMed
Wassef, A, Watson, DJ, Morrison, P, Bryant, S, Hack, J.Neuroleptic- valproic acid combination in treatment of psychotic symptoms: a three-case report. J Clin Psychopharmacol 1989;9:45-8.CrossRefGoogle ScholarPubMed
Wolkowitz, OM, Pickar, D.Benzodiazepines in the treatment of schizophrenia: a review and reappraisal. Am J Psychiatr 1991;148:714-26.Google ScholarPubMed