Oxcarbazepine in Patients With Impulsive Aggression

Mattes, Jeffrey A.

doi:10.1097/01.jcp.0000186739.22395.6b

Cited by 69 publications

(69 citation statements)

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“…Two studies in the treatment of adult bipolar disorder have been promising. In a double-blind, placebo-controlled trial of oxcarbazepine in patients with impulsive aggression and no known psychiatric comorbidities, analyses showed consistent evidence of benefit from oxcarbazepine compared with placebo [32]. …”

Section: Results and Dissussionmentioning

confidence: 99%

The Use of Antiepileptic Drugs (AEDs) for the Treatment of Pediatric Aggression and Mood Disorders

et al. 2010

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Aggressive symptomatology presents across multiple psychiatric, developmental, neurological and behavioral disorders, complicating the diagnosis and treatment of the underlying pathology. Anti-Epileptic Drugs (AEDs) have become an appealing alternative in the treatment of aggression, mood lability and impulsivity in adult and pediatric populations, although few controlled trials have explored their efficacy in treating pediatric populations. This review of the literature synthesizes the available data on ten AEDs—valproate, carbamazepine, oxcarbazepine, phenytoin, lamotrigine, topiramate, levetiracetam, zonisamide, gabapentin and tiagabine—in an attempt to assess evidence for the efficacy of AEDs in the treatment of aggression in pediatric populations. Our review revealed modest evidence that some of the AEDs produced improvement in pediatric aggression, but controlled trials in pediatric bipolar disorder have not been promising. Valproate is the best supported AED for aggression and should be considered as a first line of treatment. When monotherapy is insufficient, combining an AED with either lithium or an atypical anti-psychotic can result in better efficacy. Additionally, our review indicates that medications with predominately GABA-ergic mechanisms of action are not effective in treating aggression, and medications which decrease glutaminergic transmission tended to have more cognitive adverse effects. Agents with multiple mechanisms of action may be more effective.

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Section: Results and Dissussionmentioning

confidence: 99%

The Use of Antiepileptic Drugs (AEDs) for the Treatment of Pediatric Aggression and Mood Disorders

et al. 2010

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“…Recent trials with levetiracetam and oxcarbazepine for impulsive aggression recruited individuals with IED without significant comorbidity (e.g. Mattes, 2005Mattes, , 2008, while other trials recruited subjects with personality disorders and a history of impulsive aggression (e.g. Coccaro et al 2009 ;Hollander et al 2003).…”

Section: Other Personality Disorders Maladaptive Traitsmentioning

confidence: 99%

Evidence-based pharmacotherapy for personality disorders

Ripoll

Triebwasser

Siever

2011

Int. J. Neuropsychopharm.

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Patients with personality disorders are prescribed psychotropic medications with greater frequency than almost any other diagnostic group. Prescribing practices in these populations are often based on anecdotal evidence rather than rigorous data. Although evidence-based psychotherapy remains an integral part of treatment, Axis II psychopathology is increasingly conceptualized according to neurobiological substrates that correspond to specific psychopharmacological strategies. We summarize the best available evidence regarding medication treatment of personality disordered patients and provide optimal strategies for evidence-based practice. Most available evidence is concentrated around borderline and schizotypal personality disorders, with some additional evidence concerning the treatment of avoidant and antisocial personality disorders. Although maladaptive personality symptoms respond to antidepressants, antipsychotics, mood stabilizers, and other medications, evidence-based pharmacotherapy is most useful in treating circumscribed symptom domains and induces only partial improvement. Most available evidence supports use of medication in reducing impulsivity and aggression, characteristic of borderline and antisocial psychopathology. Efforts have also begun to reduce psychotic-like symptoms and improve cognitive deficits characteristic of schizotypy. Indirect evidence is also provided for psychopharmacological reduction of social anxiety central to avoidant personality disorder. Evidence-based practice requires attention to domains of expected clinical improvement associated with a medication, relative to the potential risks. The development of future rational pharmacotherapy will require increased understanding of the neurobiological underpinnings of personality disorders and their component dimensions. Increasing efforts to translate personality theory and social cognitive neuroscience into increasingly specific neurobiological substrates may provide more effective targets for pharmacotherapy.

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“…[47] Okskarbamazepinin de çift kör plasebo kontrollü çalışmalarda dürtüsel agresyonu azaltmada 1200-2400 mg/gün dozlarında anlamlı derecede etkili olduğuna dair çalışmalar bulunmaktadır. [48] Topiramat Topiramatın, BKB tanılı hastalarda dürtüsel agresif davranışları azaltmada etkili olduğu gösterilmiştir. Çift kör plasebo kontrollü çalışmalarda topramatın 250 mg/gün dozlarında öfke kontrolünde faydalı olduğuna dair kanıtlar mevcuttur.…”

Section: Karbamazepinunclassified

Impulsivity and Its Treatment

Özdemir¹,

Selvı²,

Aydın³

2012

Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychia

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ÖZETBirçok nörolojik ve psikiyatrik hastalığın temelinde yer alan ya da beraberinde seyreden dürtüselliğin tanımlanması ve tedavisinin düzenlenmesi oldukça önemlidir. Tedavide dürtüsellik ile ortaya çıkan hastalığın tedavisi ya da dür-tüsel davranışın kendisinin tedavi edilmesi şeklinde iki yola başvurulabilir. Dürtüselliğin eşlik ettiği bozukluklar arasında antisosyal ve borderline kişilik bozuklukları, şizofreni, bipolar bozukluk, dikkat eksikliği hiperaktivite bozukluğu, yeme bozuklukları, madde kullanım bozuklukları sayılabilir. Ayrıca dürtü kontrol bozuklukları olan patolojik kumar oynama, aralıklı patlayıcı bozukluk, piromani, kleptomani ve trikotillomani tanı ölçütleri içerisinde bir ölçüt olarak bulunur. Bu bozuklukların tedavi planında etkin olan davranışsal ve farmakolojik müdahalelerin bütünleştirilmesi gerekir. Bunlar içgörü yöne-limli ve bilişsel-davranışçı psikoterapiler, beklenmedik olayların yönetimi ve farmakoterapi olarak sıralanabilir. Bu yazıda, dürtüselliğin tanımı, diğer psikiyatrik bozukluklarla birlikteliği ve tedavisi aktarılmıştır. Anahtar Sözcükler: Dürtüsellik, tedavi, psikiyatrik bozukluk ABSTRACT Identification, description and therapeutic management of impulsivity, which underlies the mechanism and coexistence of many neurological and psychiatric diseases, are considered to be very crucial. Treatment can be applied in two ways; either for the disorder that occurs with impulsivity or for the treatment of the impulsive behavior itself. Disorders associated with or accompanied by impulsivity can be classified as borderline and antisocial personality disorders, schizophrenia, bipolar disorder, attention deficit and hyperactivity disorder, eating disorders, substance use disorders. In addition, impulsivity can manifest itself within the context of diagnostic criteria implicated in the impulse control disorders which include pathological gambling, intermittent explosive disorder, pyromania, kleptomania and trichotillomania. Behavioral and pharmacological interventions that are effective in treatment plans for these disorders should be integrated. These can be listed as insight-oriented psychotherapy and cognitive-behavioral psychotherapies, contingency man-

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Oxcarbazepine in Patients With Impulsive Aggression

Abstract: Oxcarbazepine appears to benefit adults with clinically significant impulsive aggression.

Cited by 69 publications

References 10 publications

The Use of Antiepileptic Drugs (AEDs) for the Treatment of Pediatric Aggression and Mood Disorders

The Use of Antiepileptic Drugs (AEDs) for the Treatment of Pediatric Aggression and Mood Disorders

Evidence-based pharmacotherapy for personality disorders

Impulsivity and Its Treatment

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