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

Post, Robert M.; Denicoff, Kirk D.; Frye, Mark A.; Dunn, Robert T.; Leverich, Gabriele S.; Osuch, Elizabeth A.; Speer, Andrew B.

doi:10.1159/000026532

Cited by 80 publications

(37 citation statements)

References 61 publications

(69 reference statements)

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“…The rationale for this indication is based on the utility of anticonvulsant medications as mood stabilizers and antidepressants in mood disorders (Goodwin and Jamison 1990;Post et al 1998;Calabrese et al 1999), the anticonvulsant properties of electroconvulsive therapy (ECT) (Sackeim et al 1983;Sackeim 1999), reports of improved mood, independent of seizure control, in epilepsy patients receiving VNS (Elger et al 2000;Harden et al 2000), the evidence from animal and human research that VNS results in altered concentrations of neurotransmitters implicated in mood disorders, including serotonin, norepinephrine, gamma aminobutyric acid, and glutamate (Ben-Menachem et al 1995;Krahl et al 1998;Walker et al 1999), and brain imaging findings that acute VNS results in modulation of functional activity in widespread cortical and subcortical brain regions ; see George et al 2000a,b for reviews).…”

mentioning

confidence: 99%

Vagus Nerve Stimulation (VNS™) for Treatment-Resistant Depression Efficacy, Side Effects, and Predictors of Outcome

Sackeïm

Rush²,

George

et al. 2001

Neuropsychopharmacology

493

243

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mentioning

confidence: 99%

Vagus Nerve Stimulation (VNS™) for Treatment-Resistant Depression Efficacy, Side Effects, and Predictors of Outcome

Sackeïm

Rush²,

George

et al. 2001

Neuropsychopharmacology

493

243

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“…The subsequent demonstration of carbamazepine's optimal usefulness against amygdala vs. cortical-kindled seizures [229], and the development of the kindling model of recurrent affective illness by Post, led to a more systematic investigation of its efficacy in recurrent affective disorders. Ballenger and Post reported the first controlled studies of carbamazepine efficacy in acute mania [230] in 1978, after which a number of studies have replicated this finding [23].…”

Section: Carbamazepinementioning

confidence: 99%

“…In 1968 Dehing reported that carbamazepine decreased aggression in some chronic psychiatric patients [225]. However, carbamazepine's efficacy in complex partial seizures of the temporal lobe, its positive psychotrophic profile in patients with such seizure disorders [226], the wealth of data implicating limbic dysfunction in disorders of affect, its antiaggressive effects, and the fact that it was a CNS-penetrant agent which reduced neuronal excitability led to its use as a potential antimanic agent [23]. The clinical efficacy of carbamazepine in the treatment of acute mania was first reported by Takezaki and Hanaoka (1971) in a small open trial [227], followed by a larger open trail by Okuma and colleagues (1975) [228].…”

Section: Carbamazepinementioning

confidence: 99%

“…With respect to VPA and carbamazepine, the antiepileptic properties of these drugs may be the same targets as those that exert mood stabilizing properties [11,22,23]. However, in general, antiepileptic medications exert their effects quite rapidly, suggesting that their wellcharacterized effects on ion channels and excitatory and inhibitory amino acid neurotransmitters per se may play a major role in their antiseizure effects.…”

Section: Introductionmentioning

confidence: 99%

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Mood stabilizer psychopharmacology

Gould

Chen

Manji

2002

Clinical Neuroscience Research

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Mood stabilizers represent a class of drugs that are efficacious in the treatment of bipolar disorder. The most established medications in this class are lithium, valproic acid, and carbamazepine. In addition to their therapeutic effects for treatment of acute manic episodes, these medications often are useful as prophylaxis against future episodes and as adjunctive antidepressant medications. While important extracellular effects have not been excluded, most available evidence suggests that the therapeutically relevant targets of this class of medications are in the interior of cells. Herein we give a prospective of a rapidly evolving field, discussing common effects of mood stabilizers as well as effects that are unique to individual medications. Mood stabilizers have been shown to modulate the activity of enzymes, ion channels, arachidonic acid turnover, G protein coupled receptors and intracellular pathways involved in synaptic plasticity and neuroprotection. Understanding the therapeutic targets of mood stabilizers will undoubtedly lead to a better understanding of the pathophysiology of bipolar disorder and to the development of improved therapeutics for the treatment of this disease. Furthermore, the involvement of mood stabilizers in pathways operative in neuroprotection suggests that they may have utility in the treatment of classical neurodegenerative disorders.

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“…Após sua administração crônica, ela demonstrou efeitos noradrenérgicos, dopaminérgicos e moduladores do sistema GABAérgico, que aumentaram os níveis de GABA no cérebro e no liquor. No entanto, não se sabe como a carbamazepina atuaria nos transtornos do humor (Post et al, 1998).…”

Section: Carbamazepinaunclassified

Depressão resistente a tratamento: uma revisão das estratégias farmacológicas de potencialização de antidepressivos

Santos¹,

Hara

Stumpf³

et al. 2006

J. bras. psiquiatr.

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ResumoObjetivo: Fazer uma revisão sobre oito estratégias farmacológicas de potencialização de antidepressivos na DRT. Métodos: Fez-se um levantamento bibliográfico de 1990 até janeiro de 2006, nas bases eletrônicas de busca Medline, LILACS e da Biblioteca Cochrane, utilizando-se os termos de busca treatment, resistant, refractory e depression e os descritores depression, drug resistance e augmentation, incluindo apenas ensaios controlados duplo-cegos. Foi consultada a referência dos artigos para obtenção de ensaios realizados em data anterior a 1990 e artigos originais de valor histórico. Resultados: Foram encontrados 17 estudos duplo-cegos com o lítio, seis com o hormônio tireoidiano, dois com a buspirona, seis com o pindolol, um com a carbamazepina, dois com a lamotrigina e quatro com a olanzapina. Foram favoráveis à potencialização 41,2% dos ensaios com lítio; 60% daqueles com hormônio tireoidiano e antidepressivos tricíclicos e nenhum com hormônio tireoidiano e inibidores seletivos da recaptação da serotonina (ISRS); 50% dos com pindolol; 100% dos ensaios com carbamazepina e 40% daqueles com olanzapina. Nenhum dos estudos com a buspirona foi favorável. No único estudo com lamotrigina não houve eficácia de tratamento na avaliação pelo critério principal, mas superioridade ao placebo em critérios secundários. Conclusão: Na DRT há evidência de eficácia apenas em relação ao lítio na potencialização de várias classes de antidepressivos e ao hormônio tireoidiano na potencialização de tricíclicos. A olanzapina foi razoavelmente estudada e sua eficácia não foi estabelecida. Os poucos estudos realizados com a buspirona e o pindolol não comprovaram sua eficácia. A carbamazepina foi muito pouco estudada, e a lamotrigina ainda não foi adequadamente avaliada. Palavras-chave: depressão, resistência a drogas, potencialização. AbstractObjective: The aim of this study is to review eight pharmacologic antidepressant augmentation strategies in TRD. Methods: Database search on Medline, LILACS and Cochrane Library, from 1990 to June 2006 using the words treatment, resistant, refractory, depression and the medical subject headings depression, drug resistance and augmentation. Double-blind controlled trials and reviews were included. We also consulted reference of the articles in order to obtain studies and original articles of historical value from before 1990. Results: There were 17 double-blind trials with lithium, six with thyroid hormone, two with buspirone, six with pindolol one with carbamazepine, two with lamotrigine and four with olanzapine. Forty-one percent of the trials with lithium, 60% of those with thyroid hormone and tricyclics, 0% of the ones with thyroid hormone and selective serotonin reuptake inhibitors (SSRI), 50% of those with pindolol, 100% of those with carbamazepine and 40% of the ones with olanzapine were favorable. No trials with buspirone were favorable. The only trial with lamotrigine did not show efficacy using the main outcome measures. Otherwise, there was superiority over placebo on secondary measu...

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

Cited by 80 publications

References 61 publications

Vagus Nerve Stimulation (VNS™) for Treatment-Resistant Depression Efficacy, Side Effects, and Predictors of Outcome

Vagus Nerve Stimulation (VNS™) for Treatment-Resistant Depression Efficacy, Side Effects, and Predictors of Outcome

Mood stabilizer psychopharmacology

Depressão resistente a tratamento: uma revisão das estratégias farmacológicas de potencialização de antidepressivos

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