Barbiturate Anticonvulsants in Refractory Affective Disorders

Hayes, Stephen G.

doi:10.3109/10401239309148922

Cited by 13 publications

(2 citation statements)

References 71 publications

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“…These include felbamate, gabapentin, lamotrigine, and vigabatrin. The older drugs phenytoin (Dreyfus 1981) and mysoline (Hayes 1993) have been reported as effective in some uncontrolled studies but their efficacy in bipolar illness remains largely unexplored on a systematic basis (see Table 7). …”

Section: Possible New Anticonvulsant Approaches To Mood Stabilizationmentioning

confidence: 98%

The place of anticonvulsant therapy in bipolar illness

et al. 1996

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With the increasing recognition of lithium's inadequacy as an acute and prophylactic treatment for many patients and subtypes of bipolar illness, the search for alternative agents has centered around the mood stabilizing anticonvulsants carbamazepine and valproate. In many instances, these drugs are effective alone or in combination with lithium in those patients less responsive to lithium monotherapy, including those with greater numbers of prior episodes, rapid-cycling, dysphoric mania, co-morbid substance abuse or other associated medical problems, and patients without a family history of bipolar illness in first-degree relatives. Nineteen double-blind studies utilizing a variety of designs suggest that carbamazepine, or its keto-congener oxcarbazepine, is effective in acute mania; six controlled studies report evidence of the efficacy of valproate in the treatment of acute mania as well. Fourteen controlled or partially controlled studies of prophylaxis suggest carbamazepine is also effective in preventing both manic and depressive episodes. valproate prophylaxis data, although based entirely on uncontrolled studies, appear equally promising. Thus, both drugs are widely used and are now recognized as major therapeutic tools for lithium-nonresponsive bipolar illness. The high-potency anticonvulsant benzodiazepines, clonazepam and lorazepam, are used adjunctively with lithium or the anticonvulsant mood stabilizers as substitutes or alternatives for neuroleptics in the treatment of manic breakthroughs. Preliminary controlled clinical trials suggest that the calcium channel blockers may have antimanic or mood-stabilizing effects in a subgroup of patients. A new series of anticonvulsants has just been FDA-approved and warrant clinical trials to determine their efficacy in acute and long-term treatment of mania and depression. Systematic exploration of the optimal use of lithium and the mood-stabilizing anticonvulsants alone and in combination, as well as with adjunctive antidepressants, is now required so that more definitive treatment recommendations for different types and stages of bipolar illness can be more strongly evidence based.

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Section: Possible New Anticonvulsant Approaches To Mood Stabilizationmentioning

confidence: 98%

The place of anticonvulsant therapy in bipolar illness

et al. 1996

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“…Another antiabsence mography (PET) or blood flow using 15 O PET. Preliminary data of Ketter et al [84] have indicated that those agent mysoline has been reported to be effective in some add-on studies by Hayes [91]. patients with baseline hypermetabolism are more likely to respond to carbamazepine, whereas those with hypometabolism are more likely to respond to the calcium Acetazolamide Acetazolamide is a carbonic anhydrase inhibitor channel blocker and putative anticonvulsant nimodipine.…”

Section: Ethosuximide and Mysolinementioning

confidence: 99%

A History of the Use of Anticonvulsants as Mood Stabilizers in the Last Two Decades of the 20th Century

et al. 1998

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Anticonvulsants have moved into an important position as alternatives and adjuncts to lithium carbonate in the treatment of bipolar illness. Work with the nonhomologous model of kindled seizures helped in the choice of carbamazepine as a potential mood stabilizer and in the study of the mechanisms of action of the second generation anticonvulsants carbamazepine and valproate, as well as the putative third generation psychotropic anticonvulsants lamotrigine and gabapentin. Anticonvulsant neuropeptides such as TRH and nonconvulsant approaches with repeated transcranial magnetic stimulation (rTMS) also appear promising.

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Antiepileptic drugs in the treatment of psychiatric disorders

Kaufman

2011

Epilepsy & Behavior

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Barbiturate Anticonvulsants in Refractory Affective Disorders

Cited by 13 publications

References 71 publications

The place of anticonvulsant therapy in bipolar illness

The place of anticonvulsant therapy in bipolar illness

A History of the Use of Anticonvulsants as Mood Stabilizers in the Last Two Decades of the 20th Century

Antiepileptic drugs in the treatment of psychiatric disorders

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