Lamotrigine for schizophrenia

Premkumar, Titus Samson; Pick, Jamie

doi:10.1002/14651858.cd005962.pub2

Cited by 40 publications

(15 citation statements)

References 39 publications

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“…This considerable reduction of mortality rate in the 1980s was mainly a result of a significant fall in unnatural deaths over the period (ie, the mortality ratio of suicide decreased from 6,110 in 1981–1986 to 0 in 1986–1991). In addition, the findings of the study support previous findings that people with schizophrenia have a mortality between two and three times that of the general populations,74 as well as raise concern about the cardiovascular mortality of schizophrenia, which has significantly increased during the past 25 years 80. Nevertheless, the effects of clozapine and other second-generation antipsychotics on mortality and treatment compliance among patients with schizophrenia reveal the difficulties in linking medium- or long-term patient outcomes with short-term drug effects; that is, whether symptom reduction can be mainly explained by the efficacy of antipsychotic use.…”

Section: Safety and Tolerability Of Antipsychoticssupporting

confidence: 86%

Current approaches to treatments for schizophrenia spectrum disorders, part I: an overview and medical treatments

Chien¹,

Yip²

2013

NDT

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During the last three decades, an increasing understanding of the etiology, psychopathology, and clinical manifestations of schizophrenia spectrum disorders, in addition to the introduction of second-generation antipsychotics, has optimized the potential for recovery from the illness. Continued development of various models of psychosocial intervention promotes the goal of schizophrenia treatment from one of symptom control and social adaptation to an optimal restoration of functioning and/or recovery. However, it is still questionable whether these new treatment approaches can address the patients’ needs for treatment and services and contribute to better patient outcomes. This article provides an overview of different treatment approaches currently used in schizophrenia spectrum disorders to address complex health problems and a wide range of abnormalities and impairments resulting from the illness. There are different treatment strategies and targets for patients at different stages of the illness, ranging from prophylactic antipsychotics and cognitive–behavioral therapy in the premorbid stage to various psychosocial interventions in addition to antipsychotics for relapse prevention and rehabilitation in the later stages of the illness. The use of antipsychotics alone as the main treatment modality may be limited not only in being unable to tackle the frequently occurring negative symptoms and cognitive impairments but also in producing a wide variety of adverse effects to the body or organ functioning. Because of varied pharmacokinetics and treatment responsiveness across agents, the medication regimen should be determined on an individual basis to ensure an optimal effect in its long-term use. This review also highlights that the recent practice guidelines and standards have recommended that a combination of treatment modalities be adopted to meet the complex health needs of people with schizophrenia spectrum disorders. In view of the heterogeneity of the risk factors and the illness progression of individual patients, the use of multifaceted illness management programs consisting of different combinations of physical, psychological, and social interventions might be efficient and effective in improving recovery.

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Section: Safety and Tolerability Of Antipsychoticssupporting

confidence: 86%

Current approaches to treatments for schizophrenia spectrum disorders, part I: an overview and medical treatments

Chien¹,

Yip²

2013

NDT

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“…A recent review of five relevant trials on lamotrigine for schizophrenia (Premkumar and Pick, 2006) has shown that the addition of lamotrigine may have a positive effect on the symptoms of schizophrenia, while it did not seem to have beneficial effects on cognitive functions; the authors concluded that more studies with larger samples are needed to confirm the real magnitude of efficacy and safety.…”

Section: Introductionmentioning

confidence: 99%

The effect of lamotrigine augmentation of clozapine in a sample of treatment-resistant schizophrenic patients: A double-blind, placebo-controlled study

Zoccali

Muscatello

Bruno

et al. 2007

Schizophrenia Research

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Based on the evidence that lamotrigine added to clozapine in refractory schizophrenic patients has reported promising results, the present 24-week double-blind, randomized, placebo-controlled trial had the aim to explore the efficacy of lamotrigine add-on pharmacotherapy on clinical symptomatology and cognitive functioning in a sample of treatment-resistant schizophrenic patients receiving clozapine. After clinical and neurocognitive assessments patients were randomly allocated to receive, in a double-blind design, either up to 200 mg/day of lamotrigine or a placebo. A final sample of fifty-one patients completed the study.The results obtained indicate that lamotrigine added to stable clozapine treatment showed a beneficial effect on the negative, positive and general psychopathological symptomatology in a sample of treatment-resistant schizophrenic patients. Regarding cognitive functions, improvement was observed in some explored areas, such as attentional resistance to interference, verbal fluency and executive functioning. The findings provide evidence that lamotrigine augmentation of clozapine treatment is well tolerated and may be proposed as an effective therapeutic strategy to improve outcome in treatment-resistant schizophrenia.

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“…The treatment options for negative symptoms are also extremely limited [37]. Various treatment strategies have been studied, in which several types of medications were added to antipsychotics in order to alleviate negative symptoms, for example adjunct antidepressants [38], lamotregene [39], mirtazapine [40] and other mood stabilizers [41]. Further identification and treatment of negative symptoms is important in order to improve outcome in first episode schizophrenia.…”

Section: Discussionmentioning

confidence: 99%

Study of negatives symptoms in first episode schizophrenia

Bambole¹,

Shah²,

Sonavane³

et al. 2013

OJPsych

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Background: Prevalence of negative symptoms in the early phase of schizophrenia remains uncertain. Negative symptoms are the primary cause of long term disability and poor functional outcome. The purpose of this study is to examine the presence of negative symptoms in patients with fist episode psychosis in schizophrenia who were hospitalized. Methods: Negative symptoms were measured in 72 patients presenting with FEP using the scale for assessment of negative symptoms (SANS) and ascertained diagnosis using DSM-IV. Prevalence of SANS items and subscales were examined for both schizophrenia and bipolar disorder. Results: This study shows that a significant number of patients with first episode schizophrenia had negative symptoms 66 (87.5%). All five subtypes of negative symptoms were present in 47% of patients suggesting primary negative symptoms, and about 40% have secondary negative symptoms. Independently, each subtype of negative symptoms was seen in 48% -76% of patients. The most prevalent negative symptom in first-episode schizophrenia was found to be blunting (72%). 46% of patients had significant level of depression, overall psychopathology was severe and level of functioning was poor. We found that 45.8% patients were prescribed anticholinergic medications which indicated that at least 45% subjects had extra-pyramidal symptoms (EPS). Conclusion: Primary negative symptoms are prevalent in about half of First episode Psychosis (FEP) schizophrenia patients. These findings have implications for identification, early treatment, and reduced treatment resistance for negative symptoms in order to increase social and clinical outcome of schizophrenia. Further research is required in this area.

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Lamotrigine for schizophrenia

Cited by 40 publications

References 39 publications

Current approaches to treatments for schizophrenia spectrum disorders, part I: an overview and medical treatments

Current approaches to treatments for schizophrenia spectrum disorders, part I: an overview and medical treatments

The effect of lamotrigine augmentation of clozapine in a sample of treatment-resistant schizophrenic patients: A double-blind, placebo-controlled study

Study of negatives symptoms in first episode schizophrenia

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