Psychiatria pre prax 4/2008

ANTIEPILEPTIC DRUGS IN THE TREATMENT OF SCHIZOPHRENIA SPECTRUM PSYCHOSES

Antipsychotics are the first-choice treatment in schizophrenia and related psychoses. Because almost 20 per cent of patients do not respond to antipsychotics alone, combination treatment with antiepileptics is a subject of interest. We review the most recent knowledge in this field based on the mechanism of action of individual antiepileptics. High doses of benzodiazepines may be effective in positive symptoms of schizophrenia, anxiety and agitation. Augmentation of antipsychotics with carbamazepine may be beneficial in violent patients, subjects with affective symptoms and EEG abnormalities. Positive symptoms, irritability, hostility and aggressiveness in schizophrenia are reduced by valproate. Evaluation of effect of lamotrigine on a broad spectrum of schizophrenia-like symptoms requires further studies.

Keywords: schizophrenia, augmentation, antiepileptic drugs, GABA, glutamate