Psychiatria pre prax 2/2011

Antiepileptics in psychiatry

Based on controlled studies valproate, carbamazepine and lamotrigine have a firm position in the treatment of bipolar disorder. Besides lithium they are considered to be the most important representatives of mood stabilizers (MS). According to available guidelines MS are recommended in all phases of bipolar disorder. The aim of this retrospective study was to assess the treatment of bipolar disorder in clinical practice. Analyzing charts of patients we found that totally 71 patients (37 female, 34 male) were hospitalized 92 times (35 with mania, 53 with depression) during the 2-year period. In both mania and depression the most frequently used treatment strategy was the combination of MS and atypical antipsychotic. This is corresponding with the data about a more robust effect of combination in severe disorders requiring hospitalization. The most frequently used MS was valproate, the most frequently used antipsychotics were olanzapine and quetiapine. However, with long-term treatment the issue of side effects has to be considered (weight increase, teratogenity).

Keywords: antiepileptics, bipolar disorder, mood stabilizers, atypical antipsychotics, combination.