Carbamazepine for schizophrenia and schizoaffective psychoses

Leucht, Stefan; McGrath, John; White, Paul M.; Kissling, Werner

doi:10.1002/14651858.cd001258

Cited by 20 publications

(9 citation statements)

References 80 publications

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“…Methodological limitations include lack of randomization and/or proper blinding, short-term follow-up period, and varying definitions for refractoriness. With respect to mood stabilizer and anticonvulsant augmentation to clozapine and other atypical antipsychotics in resistant schizophrenic patients, positive results have been documented with lamotrigine (Tiihonen et al, 2003;Kremer et al, 2004) or topiramate (Tiihonen et al, 2005), whereas mixed results have been reported with lithium (Leucht et al, 2003;Kelly et al, 2006), divalproex (Basan et al, 2004;Kelly et al, 2006) and carbamazepine (Leucht et al, 2002). Caution is advised when combining agents owing to added risk of drug interactions and other safety concerns.…”

Section: Relevance To Pharmacological Treatmentmentioning

confidence: 99%

Factors affecting outcome in schizophrenia and their relevance for psychopharmacological treatment

Altamura

Bobo

Meltzer

2007

International Clinical Psychopharmacology

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A major focus of current treatment research in schizophrenia is the determinants of long-term outcome, including functional outcome and general medical well being, rather than just specific domains of psychopathology such as positive and negative symptoms, mood symptoms, and cognitive impairment. This focus does not negate the importance of the latter issues but sees them as factors contributing to long-term outcome to variable extents. A long-term treatment focus facilitates a more clinically relevant assessment of benefits versus risks of available treatments. For instance, atypical antipsychotic drugs as a group have clear advantages for several important domains of efficacy that may influence long-term outcome, but are also more expensive over the long term. Use of some agents may also result in deleterious physical health consequences as well as large additional costs over the long term owing to metabolic adverse effects. The present paper focuses on several key issues in schizophrenia which are important determinants of long-term outcome in schizophrenia, or influence choice of antipsychotic drugs, or both, including: (i) duration of untreated psychosis; (ii) impact of relapse on long-term outcome; (iii) limited efficacy for specific domains of psychopathology of current treatments; (iv) mortality owing to suicide; and (v) mortality owing to other causes (e.g. cardiovascular disease).

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Section: Relevance To Pharmacological Treatmentmentioning

confidence: 99%

Factors affecting outcome in schizophrenia and their relevance for psychopharmacological treatment

Altamura

Bobo

Meltzer

2007

International Clinical Psychopharmacology

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“…124126 The Cochrane Database of Systematic Reviews includes a meta-analysis of 10 randomized controlled trials with 258 total patients, using carbamazepine in schizophrenia and schizoaffective psychoses. 127 Carbamazepine showed no benefit for schizophrenia when matched against placebo or perphenazine. For six studies 128133 comparing antipsychotics plus carbamazepine to antipsychotics plus placebo, the meta-analysis found a nonsignificant trend toward carbamazepine reducing Brief Psychiatric Rating Scale (BPRS) scores by 20% (OR=1.96, 95% Cl 0.92-4.17, P=.O8) and 35% (OR=1.91, 95% Cl 0.89-4.07, P=.09).The few studies monitoring positive symptoms, negative symptoms, and depression did not find significant differences between carbamazepine and placebo.Two trials showed an overall improvement on carbamazepine augmentation, but these observations were based on only 38 participants.…”

Section: Schizophrenia and Schizoaffective Disordermentioning

confidence: 99%

Update: New Uses for Lithium and Anticonvulsants

Rosenberg¹,

Salzman²

2007

CNS spectr.

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Anticonvulsants are being used clinically as monotherapy and adjuncts in mental illnesses other than affective disorders. This review focuses on the literature for anticonvulsants and lithium in substance use disorders, anxiety disorders, and schizophrenia. Given the abuse potential and other difficulties with prescribing benzodiazepines for alcohol and benzodiazepine withdrawal, anticonvulsants have been considered as an alternative. Promising therapeutic effects have been demonstrated in many of the anxiety disorders, with the greatest number of trials and positive results in posttraumatic stress disorder. Although anticonvulsant and lithium augmentation for schizophrenia is common in practice and has been studied in double-blind, randomized, controlled trials, the sum of the evidence has been inconclusive.

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“…Antipsychotics augmented with carbamazapine have shown mixed results in the improvement of positive and negative symptoms in schizophrenia [27]. Interestingly, most patients were taking haloperidol; its metabolism may have been induced by carbamazepine, leading to lower levels, less extrapyramidal side effects and improvement in the negative symptoms (see Table II).…”

Section: Anticonvulsantsmentioning

confidence: 99%

Polypharmacy in schizophrenia

Masand

Tharwani

Patkar

2006

International Journal of Psychiatry in Clinical Practice

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In contrast to research studies that limit the use of concomitant psychotropic medications in the treatment of schizophrenia, polypharmacy is common in real-world, clinical practice. The use of psychotropic medications as an adjunct to antipsychotic agents is often necessitated by the poor response to monotherapy with one antipsychotic agent. This paper discusses the prevalence of polypharmacy in clinical settings, reviews the evidence for the adjunctive use of antipsychotics, anticonvulsants, lithium, antidepressants, benzodiazepines and other psychotropics in the treatment of schizophrenia, and offers suggestions toward use of polypharmacy in difficult and practical clinical settings.

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Carbamazepine for schizophrenia and schizoaffective psychoses

Cited by 20 publications

References 80 publications

Factors affecting outcome in schizophrenia and their relevance for psychopharmacological treatment

Factors affecting outcome in schizophrenia and their relevance for psychopharmacological treatment

Update: New Uses for Lithium and Anticonvulsants

Polypharmacy in schizophrenia

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