Vigabatrin-induced forced normalization and psychosis — Prolongated termination of behavioral symptoms but persistent antiepileptic effect after withdrawal

Weber, Peter; Dill, Patricia; Datta, Alexandre N.

doi:10.1016/j.yebeh.2012.03.005

Cited by 14 publications

(8 citation statements)

References 17 publications

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“…In the first of three case studies, Weber et al (2012) reported psychosis associated with vigabatrin in an adolescent girl with refractory symptomatic epilepsy after an early middle cerebral artery insult. The onset of the psychosis was 7 weeks after the vigabatrin was commenced, when she had been seizure free for 2 weeks.…”

Section: Aggression With Antiepileptic Drugs In Children and Teenmentioning

confidence: 99%

Epilepsy, Antiepileptic Drugs, and Aggression: An Evidence-Based Review

et al. 2016

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Antiepileptic drugs (AEDs) have many benefits but also many side effects, including aggression, agitation, and irritability, in some patients with epilepsy. This article offers a comprehensive summary of current understanding of aggressive behaviors in patients with epilepsy, including an evidence-based review of aggression during AED treatment. Aggression is seen in a minority of people with epilepsy. It is rarely seizure related but is interictal, sometimes occurring as part of complex psychiatric and behavioral comorbidities, and it is sometimes associated with AED treatment. We review the common neurotransmitter systems and brain regions implicated in both epilepsy and aggression, including the GABA, glutamate, serotonin, dopamine, and noradrenaline systems and the hippocampus, amygdala, prefrontal cortex, anterior cingulate cortex, and temporal lobes. Few controlled clinical studies have used behavioral measures to specifically examine aggression with AEDs, and most evidence comes from adverse event reporting from clinical and observational studies. A systematic approach was used to identify relevant publications, and we present a comprehensive, evidence-based summary of available data surrounding aggression-related behaviors with each of the currently available AEDs in both adults and in children/adolescents with epilepsy. A psychiatric history and history of a propensity toward aggression/anger should routinely be sought from patients, family members, and carers; its presence does not preclude the use of any specific AEDs, but those most likely to be implicated in these behaviors should be used with caution in such cases.

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Section: Aggression With Antiepileptic Drugs In Children and Teenmentioning

confidence: 99%

Epilepsy, Antiepileptic Drugs, and Aggression: An Evidence-Based Review

et al. 2016

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“…The other problem is more controversial. Some antiepileptic drugs, such as vigabatrin [Weber et al 2012], phenytoin, zonisamide [Noguchi et al 2012], and topiramate [Khan et al 1999], have been reported to show adverse psychotropic effects. If these suggestions are reliable enough, replacement of these antiepileptics in the case of the occurrence of psychosis seems to be mandatory.…”

Section: Tle (%)mentioning

confidence: 99%

Psychotic illness in patients with epilepsy

Kanemoto

Tadokoro

Oshima

2012

Ther Adv Neurol Disord

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Apart from the rather rare ictal psychotic events, such as non-convulsive status epilepticus, modern epileptic psychoses have been categorized into three main types; chronic and acute interictal psychoses (IIPs) and postictal psychosis (PIP). Together, they comprise 95% of psychoses in patients with epilepsy (PWE). Four major questions, that is, "Is psychosis in PWE a direct consequence of epilepsy or schizophrenia induced by epilepsy?", "Is psychosis in PWE homogeneous or heterogeneous?", "Does psychosis in PWE have symptomatological differences from schizophrenia and related disorders?", "Is psychosis in PWE uniquely associated with temporal lobe epilepsy (TLE)?" are tried to be answered in this review with relevant case presentations. In the final section, we propose a tentative classification of psychotic illness in PWE, with special attention to those who have undergone epilepsy surgery. Psychotic disorders in PWE are often overlooked, mistreated, and consequently lingering on needlessly. While early diagnosis is unanimously supported as a first step to avoid this delay, necessity of switching from antiepileptic drugs with supposedly adverse psychotopic effects. to others is more controversial. To elucidate the riddle of alternative psychosis, we need badly further reliable data.

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“…This is due to misdiagnosis as depression at the start with delay of administration of dopamine-blockers. Moreover some antiepileptic drugs, such as vigabatrin [38], phenytoin, zonisamide [39], and topiramate [40], have been reported to show adverse psychotropic effect but this is still controversial [41]. Interictal psychoses seem most troublesome to differentiate from a pure psychiatric illness.…”

Section: Level Ii: Epileptic Psychosismentioning

confidence: 99%

Semiological Bridge between Psychiatry and Epilepsy

Gaber¹

2017

JPCPY

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DiscussionEpilepsy is a brain disorder characterized by an enduring predisposition of recurrent seizures. Seizure is a transient recurrent disturbance of behavior due to excessive or synchronous neuronal activity in the brain [1]. The behavioral disturbance in seizure involves disruption of one of four spheres that represents the semiology (phenomenology) of seizures. These spheres are the sensorial sphere, consciousness sphere, autonomic sphere and the motor sphere [2]. The behavioral disturbances in these four spheres may mimic psychiatric non epileptic phenomena in there semiology, that may lead to confusion in diagnosis whether the patient is epileptic or a psychiatric disorder. This mimicry occurs on three levels constituting a grey zone. The first level is the semiology itself, that the behavioral phenomenon at a time can be the presentation of an epileptic disorder and at another time a representation of a psychiatric disorder. The second level is the comorbidity between epilepsy and psychiatric disorders namely epileptic psychosis. The third level is the disorders of the brain that can present by both epileptic and/or psychiatric disorders e.g. NMDA encephalitis. Here we review these three levels of Semiological Bridge between psychiatry and epilepsy.

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Vigabatrin-induced forced normalization and psychosis — Prolongated termination of behavioral symptoms but persistent antiepileptic effect after withdrawal

Cited by 14 publications

References 17 publications

Epilepsy, Antiepileptic Drugs, and Aggression: An Evidence-Based Review

Epilepsy, Antiepileptic Drugs, and Aggression: An Evidence-Based Review

Psychotic illness in patients with epilepsy

Semiological Bridge between Psychiatry and Epilepsy

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