A double‐blind study of adjunctive carbamazepine versus placebo on excited states of schizophrenic and schizoaffective disorders

Okuma, Takashi; Yamashita, Itaru; Takahashi, Ryo; Itoh, Hidenori; Otsuki, Saburo; Watanabe, Shinta; Sarai, Keisuke; Hazama, Hidebumi; Inanaga, Kazutoyo

doi:10.1111/j.1600-0447.1989.tb01334.x

Cited by 79 publications

(24 citation statements)

References 16 publications

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“…Anticonvulsant agents are widely prescribed to enhance neuroleptic efficacy (Baldessarini et al 1995;Citrome et al 1998;Wilson et al 1985). However, there are limited supporting data for this application of anticonvulsants in schizophrenic patients (Carpenter et al 1991;Casey et al 2003;Dose et al 1987Dose et al , 1998Greil et al 1997;Klein et al 1984;Nachshoni et al 1994;Okuma et al 1989).…”

Section: Therapeutic Implications Of the Disinhibition Of Glutamatergmentioning

confidence: 96%

NMDA receptor antagonist effects, cortical glutamatergic function, and schizophrenia: toward a paradigm shift in medication development

et al. 2003

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There is an urgent need to improve the pharmacotherapy of schizophrenia despite the introduction of important new medications. New treatment insights may come from appreciating the therapeutic implications of model psychoses. In particular, basic and clinical studies have employed the N-methyl-D-aspartate (NMDA) glutamate receptor antagonist, ketamine, as a probe of NMDA receptor contributions to cognition and behavior. These studies illustrate a translational neuroscience approach for probing mechanistic hypotheses related to the neurobiology and treatment of schizophrenia and other disorders. Two particular pathophysiologic themes associated with schizophrenia, the disturbance of cortical connectivity and the disinhibition of glutamatergic activity may be modeled by the administration of NMDA receptor antagonists. The purpose of this review is to consider the possibility that agents that attenuate these two components of NMDA receptor antagonist response may play complementary roles in the treatment of schizophrenia.

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Section: Therapeutic Implications Of the Disinhibition Of Glutamatergmentioning

confidence: 96%

NMDA receptor antagonist effects, cortical glutamatergic function, and schizophrenia: toward a paradigm shift in medication development

et al. 2003

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“…All diese Faktoren implizieren eine Reduktion der Kapazität der Interaktion mit anderen [118], was die Beobachtung erklärt, dass die (in einem stationären Setting unvermeidliche) Exposition mit engen Kontakten zu anderen Personen wesentlichen Einfluss auf aggressives Verhalten hat [94]. [135,136] verwendet, in den letzten Jahren in zunehmendem Ausmaû auch Valproat [127,137,138]. Positive Effekte fanden sich eher bei Patienten mit Borderline-Störungen als bei solchen mit psychotischen Erkrankungen [127,137].…”

Section: Introductionunclassified

Aggressives Verhalten psychisch Kranker im stationären Bereich: Häufigkeit, Risikofaktoren, Prävention

Schanda¹,

Taylor²

2001

Fortschr Neurol Psychiatr

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In contrast to Angloamerican and Scandinavian countries inpatient violence was not regarded as a problem in German-speaking countries for a long time. Only recently it has become a topic of increasing interest for clinical practice and research, whereby the present data exhibit significant parallels to the international development. After the discussion of methodological problems (e. g. varying definitions, sources of information, ways of registration) the paper presents the current state of knowledge about inpatient violence:Underestimation in general, mainly with respect to female patients; only a few patients are responsible for the majority of assaults; victims are rather staff members than fellow patients; discrepancy between the mostly minor physical, though major emotional consequences for victims; considerably negative effects on patient-staff interactions and ward climate. Aside from patient-related actuarial and dynamic risk factors (social origin, previous history of aggressive behaviour, dissocial personality traits and - partly - diagnoses, acute intoxication, substance abuse, lack of insight and compliance, psychotic symptoms) external/contextual factors as patient-staff ratio, ward size, structure and climate, staff-attitudes, recognition of early warning signs and handling of risk situations are of major importance for the frequency and severity of incidents. Intervention and prevention strategies are focussing - aside from medication - on the aforementioned staff-related factors and patient-staff interactions. They are the principal basis for sufficient inpatient treatment beyond the problem of violence.

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“…The evidence for efficacy comes mostly from small trials or case reports, 74-80 but the results of a larger trial (n = 162) are also available. 81 In this latter report, a randomized clinical trial of carbamazepine in patients with DSM-III schizophrenia or schizoaffective disorder, there was a failure to detect significant improvement on the total Brief Psychiatric Rating Scale (BPRS). Differences did emerge, however, on the items of suspiciousness, uncooperativeness, and excitement.…”

Section: Combination Of Second-generation Antipsychotics and Classic mentioning

confidence: 97%

Toward Convergence in the Medication Treatment of Bipolar Disorder and Schizophrenia

Citrome¹,

Goldberg

Stahl

2005

Harvard Review of Psychiatry

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Reaching a correct differential diagnosis among patients with psychotic symptoms was especially important during the era of first-generation antipsychotics, when treatments for the different disorders varied in terms of adverse events and likelihood of response. The historical "overdiagnosis" of schizophrenia and "underdiagnosis" of bipolar disorder in the United States was blamed for an increased exposure to neuroleptics among patients who might have benefited from lithium. With the recognition that second-generation antipsychotics are useful in the treatment of both schizophrenia and bipolar mania, and that combining them with classic mood stabilizers such as valproate may results in increased efficacy, the field is witnessing a convergence of pharmacological approaches to the treatment of schizophrenia and bipolar disorder. Substantially more data is available regarding combination treatments for bipolar disorder than for schizophrenia, and appropriate diagnosis remains important in predicting prognosis, but until the precise pathophysiology of psychotic disorders can be elucidated, and specific targeted treatments crafted, we will continue to see similar blended treatments for these two disease states.

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A double‐blind study of adjunctive carbamazepine versus placebo on excited states of schizophrenic and schizoaffective disorders

Cited by 79 publications

References 16 publications

NMDA receptor antagonist effects, cortical glutamatergic function, and schizophrenia: toward a paradigm shift in medication development

NMDA receptor antagonist effects, cortical glutamatergic function, and schizophrenia: toward a paradigm shift in medication development

Aggressives Verhalten psychisch Kranker im stationären Bereich: Häufigkeit, Risikofaktoren, Prävention

Toward Convergence in the Medication Treatment of Bipolar Disorder and Schizophrenia

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