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Antiepileptic drugs in schizophrenia: a review

Published online by Cambridge University Press:  16 April 2020

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).
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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.

Type
Review
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2002

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