Efficacy of carbamazepine in assaultive patients with forntal lobe dysfunction

Foster, Hilliard G.; Hillbrand, Marc; Carl, C

doi:10.1016/0278-5846(89)90038-9

Cited by 38 publications

(17 citation statements)

References 5 publications

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“…This last medication demonstrated significant efficacy in different populations of aggressive subjects [129, 130]. Carbamazepine has also shown some efficacy in a small double-blind study and in open-label trials [131, 132]. Phenytoin has showed positive results in two controlled double-blind studies [133, 134] at doses up to 300 mg/d.…”

Section: Treatment Options For Icdsmentioning

confidence: 99%

Epidemiologic and clinical updates on impulse control disorders: a critical review

Dell’Osso

Altamura

Allen

et al. 2006

Eur Arch Psychiatry Clin Neurosci

224

114

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Section: Treatment Options For Icdsmentioning

confidence: 99%

Epidemiologic and clinical updates on impulse control disorders: a critical review

Dell’Osso

Altamura

Allen

et al. 2006

Eur Arch Psychiatry Clin Neurosci

224

114

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“…Thus, divalproex may warrant further study in SMD youth. Carbamazepine is another AED that has been studied in treating irritability in children, adolescents, and adults (Mattes et al 1984; Foster et al 1989; Kowatch et al 2000). However, in studies of children and adolescents, carbamazepine has not shown significant superiority to placebo in treating aggressive youth (Cueva et al 1996), and a recent, large double-blind randomized placebo controlled trial of BD youth failed to demonstrate significant benefit from oxcarbazepine (Wagner et al 2006).…”

Section: Discussionmentioning

confidence: 99%

Randomized Double-Blind Placebo-Controlled Trial of Lithium in Youths with Severe Mood Dysregulation

Dickstein

Towbin²,

Veen³

et al. 2009

Journal of Child and Adolescent Psychopharmacology

130

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Objective The diagnosis and treatment of youth with severe nonepisodic irritability and hyperarousal, a syndrome defined as severe mood dysregulation (SMD) by Leibenluft, has been the focus of increasing concern. We conducted the first randomized double-blind, placebo-controlled trial in SMD youth, choosing lithium on the basis of its potential in treating irritability and aggression and neuro-metabolic effects. Methods SMD youths 7–17 years were tapered off their medications. Those who continued to meet SMD criteria after a 2-week, single-blind, placebo run-in were randomized to a 6-week double-blind trial of either lithium (n = 14) or placebo (n = 11). Clinical outcome measures were: (1) Clinical Global Impressions–Improvement (CGI-I) score less than 4 at trial’s end and (2) the Positive and Negative Syndrome Scale (PANSS) factor 4 score. Magnetic resonance spectroscopy (MRS) outcome measures were myoinositol (mI), N-acetyl-aspartate (NAA), and combined glutamate/glutamine (GLX), all referenced to creatine (Cr). Results In all, 45% (n = 20/45) of SMD youths were not randomized due to significant clinical improvement during the placebo run-in. Among randomized patients, there were no significant between-group differences in either clinical or MRS outcome measures. Conclusion Our study suggests that although lithium may not result in significant clinical or neurometabolic alterations in SMD youths, further SMD treatment trials are warranted given its prevalence.

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“…The Freeman study was noteworthy, however, in that an excellent response to lithium in dysphoric mania was also observed, in contrast to other studies. The collaborative study by Bowden et al Okuma et al (1973Okuma et al ( , 1975 3/9 BP Wunderlich et al (1983) 11/13 BP/UP Folks et al (1982) 3/4 2 BP Neumann et al (1984) 5/5 BP 2 UP Barker and Eccleston (1984) 1/1 UP Schaffer et al (1985) 1/1 UP Sethi and Tiwari (1984) 3/5 BP/UP Post et al (1986, unpublished) 17/57 BP/UP Arap Mengech (1985) 1/5 BP Foster et al (1989) 4/4 2°Dep. Nurnberg and Finkel (1985) 1/1 BP Small [1989, unpublished 9/28 BP/UP as cited in Small (1990)] Prasad (1985) 11/12 UP Stuppaeck et al (1990) 20/24 6 BP 18 UP Cullen et al (1991) 7/16 3 BP 13 UP Svestka et al (1991) 24/37 UP Dilsaver et al (1994) 17 1994), which represents the largest placebo-controlled trial in mania to date, revealed a significant antimanic effect of valproate and lithium compared with placebo on several different measures.…”

Section: Valproatementioning

confidence: 96%

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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Efficacy of carbamazepine in assaultive patients with forntal lobe dysfunction

Cited by 38 publications

References 5 publications

Epidemiologic and clinical updates on impulse control disorders: a critical review

Epidemiologic and clinical updates on impulse control disorders: a critical review

Randomized Double-Blind Placebo-Controlled Trial of Lithium in Youths with Severe Mood Dysregulation

The place of anticonvulsant therapy in bipolar illness

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