Antikonvulsiva und ihre psychischen Wirkungen - eine Übersicht

Abstract

In a review of more than 200 studies over the last three decades, the manifold psychic effects of anticonvulsives on healthy persons, on patients with and without epilepsy, on patients with mental disorders with or without cerebral damages are analysed and summarized. The following results are mainly shown: 1. Carbamazepine: a positive effect on "expansive" behaviour and mood can be observed in about 50-60% of the patients. The cognitive and psychomotor performance is almost unchanged. 2. Valproinate: Negative psychic effects can rarely be seen for a longer time (exception: reversible encephalopathy). The behaviour can similarly be influenced as with carbamazepine. 3. Phenytoin: Cognitive and psychomotor performance is negatively influenced. The effects on behaviour are contradictory. 4. Phenobarbitone and Primidone: Diverse negative effects on performance and behaviour, especially as "expansive" disorders in children and adolescents, seemed to be proven. 5. Ethosuximide: Beside the drug specific provocation of psychotic disorders, both, positive and negative effects on behaviour and cognitive functions are discussed. 6. The psychic effects of other anticonvulsives such as Benzodiazepines, Sulthiame and Pheneturide are shortly summarized. 7. Polytherapy: Negative influences on psychic functions are significant. Finally the results are discussed concerning their clinical relevance.

Bedeutung alter und neuer Antiepileptika in der Behandlung psychischer Erkrankungen

“…Hierbei wurde insbesondere über die gute Beeinflussung psychopathologischer Auffälligkeiten von Epilepsiepatienten hingewiesen (Evans u. Gualtieri, 1985;Krüger. 1964;Blank, 1990). Hierauf gründete sich schließlich Anfang der 70er Jahre der Einsatz von Carbamazepin bei affektiven Störungen (11.…”

“…Untersuchungen über psychotrope Wirkungen der Substanz sind in geringer Zahl vorhanden, wobei diese in der Regel an Kindern durchgeführten Untersuchungen widersprüchlich sind (Blank. 1990).…”

“…1990). Einige Studien weisen auf die seltene Provokation schizophrenieähnlicher Psychosen hin (Blank. 1990).…”

Mood Effects of Zolpidem versus Phenobarbital Combined with Promethazine in an Anesthesiological Setting

“…In this study, the barbi turate was phénobarbital, a well-known sedative which mainly reduces vigilance in healthy subjects. This is repre sented in lower alertness and psychomotor performance Mood Effects of Zolpidem [ 13], Promethazine has become well established in anes thesiology because of its antihistaminic and anticholiner gic effects and in pharmacopsychological research be cause of its deactivating effects.…”

About the comorbidity of affective and conversion disorders in epilepsy

“…Барбитураты и фенитоин чаще вызывают аффективные нарушения в виде депрессивных состояний. Это позволяет некоторым авторам говорить об их депрессогенных свойствах [52][53][54][55]. Этому соответствуют данные ряда работ [56][57][58], в которых было установлено, что в популяции больных эпилепсией значительно выше риск суицидов у принимающих барбитураты лиц.…”