Advertisement

CNS Drugs

, Volume 8, Issue 6, pp 492–509 | Cite as

Psychiatric Adverse Effects of Anticonvulsant Drugs

Incidence and Therapeutic Implications
  • Ian C. K. Wong
  • Simon J. Tavernor
  • Rosalyn M. E. Tavernor
Review Articles Adverse Effects

Summary

Some anticonvulsants have been reported to be associated with psychiatric adverse reactions, such as behavioural disorders, depression, mania and psychosis. However, few systematic pharmacoepidemiological studies have investigated adverse reactions to anticonvulsant drugs, which makes accurate assessment of the incidence rate of adverse drug reactions, including psychiatrie adverse reactions, very difficult. Nevertheless, by reviewing clinical trials, observational studies and case reports, it can be concluded that patients exposed to vigabatrin or phenobarbital (phenobarbitone) are at the highest risk of developing psychiatric adverse drug reactions, those exposed to phenytoin probably at medium risk, while patients exposed to carbamazepine, valproic acid (sodium valproate) and benzodiazepines are at the lowest risk. Based on the available evidence, psychiatric adverse drug reactions attributable to lamotrigine and gabapentin are relatively infrequent, although further evidence is required to confirm this. Topiramate has only been marketed for 2 years and felbamate has only had limited use because of its propensity to cause serious nonpsychiatric adverse effects; with the relative lack of peer-reviewed reports it is very difficult to comment further on the risk of psychiatrie adverse reactions to these drugs.

Rational prescribing using: (i) monotherapy, instead of polytherapy, whenever possible; (ii) the minimal effective dosage; and (iii) escalating the dosage slowly, can reduce the risk of the patient developing psychiatrie adverse drug reactions. Pre-existing psychiatric/behavioural disorders and organic brain damage are believed to predispose patients to these reactions, and such patients should be carefully monitored.

The ideal treatment of a psychiatric adverse drug reaction is discontinuation of the offending drug; however, this may not be possible for all patients with epilepsy. In cases where it is necessary to continue anticonvulsant medication to obtain satisfactory seizure control, the psychiatric disorder should be treated concurrently with psychosocial interventions and psychotropic medication, as appropriate.

Keywords

Carbamazepine Adverse Drug Reaction Valproic Acid Gabapentin Lamotrigine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Lennox WG. Brain injury, drugs and environment as causes of mental decay in epilepsy. Am J Psychiatry 1942; 99: 174–80Google Scholar
  2. 2.
    Trimble MR, Reynolds EH. Anticonvulsant drugs and mental symptoms: a review. Psychol Med 1976; 6: 169–78PubMedGoogle Scholar
  3. 3.
    Marson AG, Kadir ZA, Chadwick DW. New antiepileptic drugs: a systematic review of their efficacy and tolerability. BMJ 1996; 313: 1169–74PubMedGoogle Scholar
  4. 4.
    Davison K, Hassanyeh F. Psychiatric disorders. In: Davies DM, editor. Textbook of adverse drug reactions. Oxford: Oxford university Press, 1981: 601–42Google Scholar
  5. 5.
    McClelland HA. Psychiatrie disorders. In: Davies DM. editor. Textbook of adverse drug reactions. Oxford: Oxford University Press. 1991: 549–77Google Scholar
  6. 6.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd rev. ed. Washington, DC: American Psychiatric Association, 1987Google Scholar
  7. 7.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington. DC: American Psychiatric Association, 1994Google Scholar
  8. 8.
    Rawlins MD. Thompson MD. Pathogenesis of adverse drug reactions. In: Davies DM, editor. Textbook of adverse drug reactions. Oxford: Oxford University Press. 1981: 11–29Google Scholar
  9. 9.
    Rawlins MD, Mann RD. Monitoring adverse events and reactions. In: Mann RD. Rawlins MD. Auty RM, editors. A textbook of pharmaceutical medicine. Camforth: Parthenon Publishing Group. 1993: 317–22Google Scholar
  10. 10.
    Johnston SJ. Vtgabatrin and behaviour disturbances [letter]. Lancet 1990; 335: 606Google Scholar
  11. 11.
    Naumann M, Supprian T, Kornhuber J, et al. Bipolar affective psychosis after vigabatrin [letter]. Lancet 1994; 343: 606–7PubMedGoogle Scholar
  12. 12.
    Landolt H. Serial EEG investigations during psychotic episodes in epileptic patients and during schizophrenic attacks. In: Lorenz de Hass AM, editor. Lectures on epilepsv. Amsterdam: Elsevier, 1958: 91–133Google Scholar
  13. 13.
    Tellenbach H. Epilepsie als Anfallsfeiden und als Psychose. Nervenartz 1965; 36: 190–202Google Scholar
  14. 14.
    Sander JWAS, Hart Y. Vigabatrin and behaviour disturbances [letter]. Lancet 1990; 335: 57PubMedGoogle Scholar
  15. 15.
    Edeh J, Toone B. Relationship between interjetai psychopathology and the type of epilepsy: results of a survey in general practice. Br J Psychiatry 1987; 151: 95–101PubMedGoogle Scholar
  16. 16.
    Zielinski JJ. Epidemiology and medical-social problems of epilepsy in Warsaw. Final report on research program no.: 19-0-58325-F-01. Washington. DC: Warsaw Psychoneurological Institute: Social and Rehabilitation Service, 1974Google Scholar
  17. 17.
    Committee on Safety of Medicines. Was the drug responsible? Curr Probl Pharmacovigilance 1993; 19: 7Google Scholar
  18. 18.
    Ounsted C. The hyperkinetic syndrome in epileptic children. Lancet 1955; 6885: 303–11Google Scholar
  19. 19.
    Wolf SM, Forsythe A, Behaviour disturbance, phenobarbital. and febrile seizures. Paediatrics 1978; 61(5): 728–31Google Scholar
  20. 20.
    Ferrari M, Barabas G, Matthews WS. Psychologie and behavioural disturbance among epileptic children treated with barbiturate antiepileptics. Am J Psychiatry 1983; 140(1): 112–3PubMedGoogle Scholar
  21. 21.
    Vining EPG, Mellits ED, Dorsen MM, et al. Psychologie and behavioural effects of anti-epileptic drugs in children: a double-blind comparison between phenobarbital and valproic acid. Paediatrics 1987; 80(2): 165–74Google Scholar
  22. 22.
    Brent DA, Crumrine PK, Varma R, et al. Phenobarbital treatment and major depressive disorder in children with epilepsy: a naturalistic follow-up. Paediatrics 1990; 85(6): 1086–91Google Scholar
  23. 23.
    Brent DA, Crumrine PK, Varma R, et al. Phenobarbital treatment and major depressive disorder in children with epilepsy. Paediatrics 1987; 80(6): 909–17Google Scholar
  24. 24.
    Domizio S, Verrotti A, Ramenghi LA, et al. Antiepileptic therapy and behaviour disturbances in children. Child Nerv Syst 1993; 9: 272–4Google Scholar
  25. 25.
    Mayhew LA, Hanzel TE, Kalachnik JE, et al. Phenobarbital exacerbation of self-injurious behaviour. J Nerv Ment Dis 1992; 180: 732–3PubMedGoogle Scholar
  26. 26.
    Kugoh T, Watanabe M, Obayashi K, et al. Two cases with epilepsy who manifested manic-depressive symptoms under barbiturates treatment. Jpn J Psychiatry Neurol 1991; 45(2): 437–8PubMedGoogle Scholar
  27. 27.
    Kugoh T, Inoue T, Utsumi T, et al. Five epileptic cases who manifested psychotic states under the toxic levels of antiepileptic drugs. Jpn J Psychiatry Neurol 1990; 44(2): 392–3PubMedGoogle Scholar
  28. 28.
    Mattson RH, Cramer JA, Collins JF A comparison of carbamazepine, phenobarbital. Phenytoin, primidone in complex partial seizures and secondarily generalised tonic-clonic seizures. N Engl J Med 1985; 313: 145–51PubMedGoogle Scholar
  29. 29.
    Robertson MM, Trimble MR, Townsend HRA. Phenomenology of depression in epilepsy. Epilepsia 1987; 28(4): 364–72PubMedGoogle Scholar
  30. 30.
    Roseman E. Dilantin toxicity. Neurology 1961; 11: 912–21PubMedGoogle Scholar
  31. 31.
    Bruni J. Phenytoin toxicity. In: Levy RH. Mattson RH, Meldrum BS, editors. Antiepileptic drugs. 4th ed. New York: Raven Press, 1995: 345–50Google Scholar
  32. 32.
    Glaser GH. Diphenylhydantoin: toxicity. In: Woodbury DM, Penry JK, Schmidt RP, editors. Antiepileptic drugs. New York: Raven Press. 1972: 219–26Google Scholar
  33. 33.
    Reynolds EH, Travers RD. Serum anticonvulsant concentrations in epileptic patients with mental symptoms: a preliminary report. Br J Psychiatry 1974; 124: 440–5PubMedGoogle Scholar
  34. 34.
    Franks RD, Richter AJ. Schizophrenia-like psychosis associated with anticonvulsant toxicity. Am J Psychiatry 1979; 136: 973–4PubMedGoogle Scholar
  35. 35.
    McDanal CE, Bolman WM. Delayed idiosyncratic psychosis with diphenylhydantoin. JAMA 1975; 231(10): 1063PubMedGoogle Scholar
  36. 36.
    Trimble MR. Psychiatric disorders in epilepsy. In: Shorvon SD, Dreifuss F. Fish D, et al., editors. The treatment of epilepsy. Oxford: Blackwell Science. 1996: 337–44Google Scholar
  37. 37.
    Post RM, Uhde TW, Roy-Byrne PP, et al. Antidepressant effects of carbamazepine. Am J Psychiatry 1986; 143: 29–34PubMedGoogle Scholar
  38. 38.
    Emrich HM, von Zerssen D, Jissling W, et al. Effects of sodium valproate in mania: the GAB A hypothesis of affective disorders. Arch Psychiatry Neurol 1980; 229: 1069–71Google Scholar
  39. 39.
    Gastaut H. lemolo F. Stuporous states or coma induced by the rapid administration of high doses of sodium valproate, Ital J Neurol Sci 1982; 3: 193–6PubMedGoogle Scholar
  40. 40.
    Sackellarcs JC, Lee SI, Dreifuss EF. Stupor following administration of valproic acid to patients receiving other ami epileptic drugs. Epilepsia 1979; 20: 697–703Google Scholar
  41. 41.
    Rangel RJ, Warner JJ, Wilder BI. Valproate encephalopathy (abstract). Epilepsia 1987; 28(5): 605Google Scholar
  42. 42.
    Chadwick DW, dimming WJK, Livingstone I, et al. Acute intoxication with sodium valproate. Ann Neurol 1979; 6: 552–3PubMedGoogle Scholar
  43. 43.
    Coulter DL, Allen RJ. Secondary hyperammonemia: a possible mechanism for valproate encephalopathy [letter]. Lancet 1980; 1: 1310PubMedGoogle Scholar
  44. 44.
    Marescaux C, Micheletti G, Warter JM, et al. Valproic de sodiu, etats stuporous et hyperammoniumie. J Med (Strasbourg) 1982; 13: 705–11Google Scholar
  45. 45.
    Campostrini R, Zaccara G, Rossi L, et al. Valproate-induced hyperammonemia in two epileptic identical twins. J Neurol 1985; 232: 167–8PubMedGoogle Scholar
  46. 46.
    Salcman M. Pippenger CE. Acute carbamazepine encephalopathy [letter]. JAMA 1975; 231(9): 915PubMedGoogle Scholar
  47. 47.
    Duche B, Louiset P, Demotes-Mainard J, et al. Encepalopathie subaigue: reaction idiosyncrasique a la carbabamazepine? Rev Neurol (Paris) 1987; 143: 211–3Google Scholar
  48. 48.
    Smith CR. Encephalomyelopathy as an idiosyncratic reaction to carbamazepine: a case report. Neurology 1991; 41: 760–1PubMedGoogle Scholar
  49. 49.
    Stommel EW. Carbamazepine encephalopathy [letter]. Neurology 1992; 42: 705PubMedGoogle Scholar
  50. 50.
    Papazian O, Canizales E, Alfonso I, et al. Reversible dementia and apparent brain atrophv during valproate therapy. Ann Neurol 1995; 38: 687–91PubMedGoogle Scholar
  51. 51.
    Zaret BS, Cohen RA. Reversible valproic acid-induced dementia: a case report. Epilepsia 1986; 27(3): 234–40PubMedGoogle Scholar
  52. 52.
    Armon C, Brown E, Carwile S, et al. Sensorineural hearing loss: a reversible effect of valproic acid. Neurology 1990; 40: 1896–8PubMedGoogle Scholar
  53. 53.
    Shin C, Gray L, Armon A, et al. Reversible cerebral atrophy: radiologic correlate of valproate-induced parkinsonism dementia syndrome. Neurology 1992; 42 Suppl. 3: 277Google Scholar
  54. 54.
    McLachlan RS. Pseudoatrophy of the brain with valproic acid monotherapy. Can J Neurol Sci 1987; 14: 294–6PubMedGoogle Scholar
  55. 55.
    Gehlen W, Froscher W, Bron B. Nebenwirkungen antiepileptischer Medikamente. Internist Prax 1978; 18: 333–9Google Scholar
  56. 56.
    Leviatov VM, Veselovskaia TD, Mar’enko GF, et al. Tegretolovye psikhozy u bolnykh shchegoleva. Ap Zh Nevgopatol Psikhiatr 1975; 75(3): 396–400Google Scholar
  57. 57.
    Mathew G. Psychiatric symptoms associated with carbamazepine [letter]. BMJ 1988; 296: 1071PubMedGoogle Scholar
  58. 58.
    Mizukami K, Naito Y, Yoshida M, et al. Mental disorders induced by carbamazepine. Jpn J Psychiatry Neurol 1990; 44: 59–63PubMedGoogle Scholar
  59. 59.
    Scull DA, Trimble MR. Mania precipitated by carbamazepine withdrawal fletter). Br J Psychiatry 1995; 167: 698PubMedGoogle Scholar
  60. 60.
    Ketter TA. Malow BA, Flamini R. et al. Carbamazepine withdrawal-emergent psychopathology [abstract]. Neurology 1993; 43 Suppl. 2: A194Google Scholar
  61. 61.
    Hillbrand M, Young JL, Krystal JH. Discontinuing anticonvulsant treatment of aggression. J Neuropsychiatry Clin Neurosei 1995; 7(1): 116–7Google Scholar
  62. 62.
    Bellman MH, Ross EM. Side-effects of sodium valproate [letter]. BMJ 1977; 1: 1662Google Scholar
  63. 63.
    Carson D, Milrod L, Labar D. Psychosis from valproate intoxication [abstract]. Epilepsia 1992; 33 Suppl. 3: A194Google Scholar
  64. 64.
    Schmidt D. Adverse effects of valproate. Epilepsia 1984; 25 Suppl. 1: S44–9PubMedGoogle Scholar
  65. 65.
    Ashton H. Guidelines for the rational use of benzodiazepines: when and what to use. Drugs 1994; 48(1): 25–40PubMedGoogle Scholar
  66. 66.
    Lader M. Benzodiazepines: a risk-benefit profile. CNS Drugs 1994; 1(5): 377–87Google Scholar
  67. 67.
    Grohmann R, Strobcl Ch, Rüther E, et al. Adverse psychic reactions to psychotropic drugs: a report from the AMUP study. Pharmacopsychiatry 1993; 26: 84–93PubMedGoogle Scholar
  68. 68.
    Schifano F, Magni G. Panic attacks and major depression after discontinuation of long term diazepam abuse. Ann Pharmacother 1989; 23: 989–90Google Scholar
  69. 69.
    Noyes R, Garvey MJ, Cook BL, et al. Benzodiazepine withdrawal: review of the evidence. J Clin Psychiatry 1988; 49: 382–9PubMedGoogle Scholar
  70. 70.
    Khan H, Joyce P, Jones AV. Benzodiazepine withdrawal syndromes. NZ Med J 1980; 92: 94–6Google Scholar
  71. 71.
    White MC, Silverman JJ, Harbison JW. Psychosis associated with clonazepam therapy for blepharospasm. J Nerv Ment Dis 1982; 170(2): 117–9PubMedGoogle Scholar
  72. 72.
    Scott DF, Moffett A. The long term effect of clobazam as adjunctive therapy in epilepsy. Acta Neurol Scand 1988; 77: 498–502PubMedGoogle Scholar
  73. 73.
    Shorvon SD. Clobazam. In: Levy RH, Mattson RH, Meldrum BS, editors. Antiepileptic drugs. New York: Raven Press. 1995: 763–78Google Scholar
  74. 74.
    Koeppen D. Clinical experience with clobazam (1968–1981). In: Hindmarch I, Stonier PD, editors. Clobazam. International Congress and Symposium Series; 43. London: Royal Society of Medicine. 1981: 193–8Google Scholar
  75. 75.
    Saletu B. Grunberger J, Berner P. et al. On differences between 1, 5 and 1.4 benzodiazepines: pharmaco-EEG and psychometric studies with clobazam and lorazepam. In: Hindmarch I, Stonier PD, Trimble MR, editors. Clobazam: human psychopharmacology and clinical applications. International Congress and Symposium Series; 74. London: Royal Society of Medicine, 1985: 23–46Google Scholar
  76. 76.
    Wolf P. Clobazam in drug-resistant patients with complex focal seizures — report of an open study. In: Hindmarch I, Stonier PD, Trimble MR. editors. Clobazam: human psychopharma-cology and clinical applications. International Congress and Symposium Series; 74. London: Royal Society of Medicine, 1985: 164–71Google Scholar
  77. 77.
    Fischer M, Korskjeer G, Pederson E. Psychotic episodes in Zarondan treatment. Epilepsia 1965; 6: 325–34PubMedGoogle Scholar
  78. 78.
    Cohadon F, Loiseau P, Cohadon S. Results of treatment of certain forms of epilepsy of the petit mal type by ethosuximide. Rev Neurol 1964; 110: 201–7Google Scholar
  79. 79.
    Lairy CC. Psychotic signs in epileptics during treatment with ethosuximide. Rev Neurol 1964; 110: 225–6Google Scholar
  80. 80.
    Sato T, Kondo Y, Matsuo T, et al. Clinical experiences of ethosuximide (Zarontin) in therapy-resistant epileptics. Brain Nerve (Tokyo) 1965; 17: 958–64Google Scholar
  81. 81.
    Roger J, Grangeon H, Guey J, et al. Psychiatric and psychological complications of ethosuximide treatment in epileptics. Encephale 1968; 57: 407–38PubMedGoogle Scholar
  82. 82.
    Sabers A, Dam M. Ethosuximide and methsuximide. In: Shorvon SD, Dreifuss F, Fish D. et al., editors. The treatment of epilepsy. Oxford: Blackwell Science, 1996: 414–20Google Scholar
  83. 83.
    Gram L, Klosterskov P, Dam M. Gamma-vinyl-GABA: a double-blind, placebo-controlled trial in partial epilepsy. Ann Neurol 1985; 17: 262–6PubMedGoogle Scholar
  84. 84.
    Loiseau P, Hardenberg JP, Pestre M, et al. Double-blind placebo-controlled study of vigabatrin (gamma-vinyl GABA) in drug-resistant epilepsy. Epilepsia 1986; 27: 115–20PubMedGoogle Scholar
  85. 85.
    Remy C, Favel P. Tell G. et al. Etude en double aveugle contre placebo en permutations croisees du vigabatrin dans I’epilepsie de l’adulte resistant a la therapeutique. Boll Lega Ital Epilepsy 1986: 54–55: 241–3Google Scholar
  86. 86.
    Rimmer EM, Richens A. A double-blind study of gamma-vinyl-GABA in patients with refractory epilepsy. Lancet 1984; 1: 189–90PubMedGoogle Scholar
  87. 87.
    Tartara A, Manni R, Galimberli CA, et al. Vigabatrin in the treatment of epilepsy: a double-blind placebo-controlled study. Epilepsia 1986; 27: 717–23PubMedGoogle Scholar
  88. 88.
    Tassinari CA, Michelucci R, Ambrosetto G, et al. Double-blind study of vigabatrin in the treatment of drug-resistant epilepsy. Arch Neurol 1987; 44: 907–10PubMedGoogle Scholar
  89. 89.
    Thomas L, Trimble M, Schmitz B. et al. Vigabatrin and behavioural disorders: a retrospective survey. Epilepsy Res 1996; 25: 21–7PubMedGoogle Scholar
  90. 90.
    Sander JWAS, Hart YM, Trimble MR, et al. Vigabatrin and psychosis. J Neurol Neurosurg Psychiatry 1991; 54: 235–9Google Scholar
  91. 91.
    Ring HA, Reynolds EH. Vigabatrin and behaviour disturbances [letter]. Lancet 1990; 335: 970PubMedGoogle Scholar
  92. 92.
    Staples CI, King MA, Boyle RS. Acute psychosis after withdrawal of vigabatrin [letter]. Med J Aust 1992; 156: 291PubMedGoogle Scholar
  93. 93.
    Dam M. Vigabatrin and behaviour disturbances [letter]. Lancet 1990; 335: 605Google Scholar
  94. 94.
    Betts T, Thomas L. Vigabatrin and behaviour disturbances [letter]. Lancet 1990; 336: 606Google Scholar
  95. 95.
    Brodie MJ, McKee PJW. Vigabatrin and behaviour disturbances [letter]. Lancet 1990; 335: 1279PubMedGoogle Scholar
  96. 96.
    Robinson MK, Richens A, Oxley R. Vigabatrin and behavioural disturbances [letter]. Lancet 1990; 336: 504PubMedGoogle Scholar
  97. 97.
    Krutschmann I, Duncan R. Evaluation of vigabatrin in refractory epilepsy (letter). J Neurol Neurosurg Psychiatry 1991; 54(9): 849PubMedGoogle Scholar
  98. 98.
    Gianelli M, Camello R, Bertucci D, et al. II Fenomeno di Landolt in tre casi di epilessia farmacoresistente trattati con vigabatrin. Boll Lega Ital Epilepsy 1993; 84: 163–6Google Scholar
  99. 99.
    Guidolin L, Minotti L, Galletta J, et al. Psychosis associated with vigabatrin [abstract]. Epilepsia 1994; 35 Suppl. 7: 67Google Scholar
  100. 100.
    Jawad S, Clarke E. Richens A. Vigabatrin-induced psychosis: management problems. Seizure 1994; 3: 309–10PubMedGoogle Scholar
  101. 101.
    Canovas-Martinez A, Ordovas-Baines JP, Beltran-Marques M, et al. Vigabatrin-associated reversible acute psychosis in a child. Ann Pharmacother 1995; 29(11): 1115–7PubMedGoogle Scholar
  102. 102.
    Cockerell OC, Moriarty J, Trimble M, et al. Acute psychological disorders in patients with epilepsy: a nation-wide study. Epilepsy Res 1996; 25: 119–21PubMedGoogle Scholar
  103. 103.
    Schmidt D, Kramer G. The new anticonvulsant drugs: implications for avoidance of adverse effects. Drug Saf 1994; 11: 422–31PubMedGoogle Scholar
  104. 104.
    Lloyd G. Psychiatry, in: Edwards CRW. Couchier RW, editors. Davidson’s principles and practices of medicine. Edinburgh: Churchill Livingstone, 1991: 929–66Google Scholar
  105. 105.
    Levinson DF, Mumford JP, Devinsky O. Vigabatrin and psychosis [abstract]. Epilepsia 1995; 36 Suppl. 4: 32Google Scholar
  106. 106.
    Ring HA, Crellin R, Kirker S, et al. Vigabatrin and depression. J Neurol Neurosurg Psychiatry 1993; 56: 925–8PubMedGoogle Scholar
  107. 107.
    Dijkstra JB, McGuire AM, Trimble MR. The effect of vigabatrin on cognitive function mood. Hum Psychopharmacol 1992; 7(5): 319–23Google Scholar
  108. 108.
    McGuire AM, Duncan JS, Trimble MR. Effects of vigabatrin on cognitive function and mood when used as add-on therapy in patients with intractable epilepsy. Epilepsia 1992; 33(1): 128–34PubMedGoogle Scholar
  109. 109.
    Piazzini A, Vignoli A, Sgro V, at al. Effects of vigabatrin on cognitive functions [abstract]. Epilepsia 1994: 35 Suppl. 7: 67Google Scholar
  110. 110.
    Thomas L, Trimble M. Effects of vigabatrin on cognitive function and mood in healthy volunteers [abstract]. Epilepsia 1994; 35 Suppl. 7: 67Google Scholar
  111. 111.
    Grunewald RA, Jackson GD, Thompson PJ, et al. Effects of vigabatrin on cognitive function [abstract]. Epilepsia 1993; 34 Suppl. 6: 78Google Scholar
  112. 112.
    Sastre-Garau P, Thomas P, Beaussart M, et al. Acces maniaque consecutif a une association vigabatrin-clomipramine [letter]. Encephale 1994; 203: 363Google Scholar
  113. 113.
    Grant SM, Heel RC. Vigabatrin: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential in epilepsy and disorders of motor control. Drugs 1991; 41: 889–926PubMedGoogle Scholar
  114. 114.
    Aldenkamp AP, Vermeulen OG, Mulder JO, et al. Gamma-vinyl GABA (vigabatrin) and mood disturbances. Epilepsia 1994; 35: 999–1004PubMedGoogle Scholar
  115. 115.
    Wong ICK. Retrospective study of vigabatrin and psychiatric/behavioural disturbances. Epilepsy Res 1995; 21(3): 227–30PubMedGoogle Scholar
  116. 116.
    Sharif MK, Sander JWAS, Shorvon SD. Acute encephalopathy with vigabatrin [letter]. Lancet 1993; 342: 619Google Scholar
  117. 117.
    Salke-Kellermann A, Baier H, Rambeck B, et al. Acute encephalopathy with vigabatrin [letter]. Lancet 1993; 342: 185PubMedGoogle Scholar
  118. 118.
    Sivenius J, Kalviainen R, Ylinen A, et al. Double-blind study of gabapentin in the treatment of partial seizures. Epilepsia 1991; 32(4): 539–42PubMedGoogle Scholar
  119. 119.
    US Gabapentin Study Group. Gabapentin as add-on therapy in refractory partial epilepsy: a double-blind, placebo-controlled. parallel-group study. Neurology 1993; 43: 2292–8Google Scholar
  120. 120.
    UK Gabapentin Study Group. Gabapentin in partial epilepsy. Lancet 1990; 335: 1114–7Google Scholar
  121. 121.
    Anhut H, Ashman P, Feuerstein TJ, et al. The International Gabapentin Study Group. Gabapentin (Neurontin) as add-on therapy in patients with partial seizures: a double-blind, placebo-controlled study. Epilepsia 1994; 35(40): 795–801PubMedGoogle Scholar
  122. 122.
    US Gabapentin Study Group. Long term safety and efficacy of gabapentin (Neurontin) as add-on therapy in drug-resistant partial epilepsy. Epilepsy Res 1994; 18(1): 67–73Google Scholar
  123. 123.
    Short C, Cook L. Hypomania induced by gabapentin. Br J Psychiatry 1995; 166: 679–80PubMedGoogle Scholar
  124. 124.
    Doherty KP, Gates JR, Penovich PE, et al. Gabapentin in a medically refractory epilepsy population: seizure response and unusual side-effects [abstract]. Epilepsia 1995; 36 Suppl. 4: 71Google Scholar
  125. 125.
    Litzinger MJ, Wiscombe N, Hanny A, et al. Increased seizures and aggression seen in persons with mental retardation and epilepsy treated with neurontin [abstract]. Epilepsia 1995; 36 Suppl. 4: 71Google Scholar
  126. 126.
    Lee DO, Steingard RJ, Cesena M, et al. Behavioural side effects of gabapentin in children. Epilepsia. 1996; 37(1): 87–90PubMedGoogle Scholar
  127. 127.
    Wolf SM, Shinnar S, Kang H, et al. Gabapentin toxicity in children manifestine as behavioural changes. Epilepsia. 1995; 36(12): 1203–5PubMedGoogle Scholar
  128. 128.
    Binnie CD, Debets RMC, Engelsman M, et al. Double-blind crossover trial of lamotrigine (Lamictal) as add-on therapy in intractable epilepsy. Epilepsy Res 1989; 4: 222–9PubMedGoogle Scholar
  129. 129.
    Jawad S, Richens A, Goodwin G, el al. Controlled trial of lamotrigine (Lamictal) for refractory partial seizures. Epilepsia 1989; 30: 356–63PubMedGoogle Scholar
  130. 130.
    Loiseau P, Yuen AWC, Duche B, et al. A randomised doubleblind, placebo-controlled crossover add-on trial of lamotrigine in patients with treatment-resistant partial seizures. Epilepsy Res 1990; 7: 136–45PubMedGoogle Scholar
  131. 131.
    Matsuo F, Bergen D, Faught E, et al. Placebo-controlled study of the efficacy and safety of lamotrigine in patients with partial seizures. Neurology 1993; 43: 2284–91PubMedGoogle Scholar
  132. 132.
    Messenheimer J, Ramsay RE, Willmorc LJ, et al. Lamotrigine therapy for partial seizures: a multicenter, placebo-controlled, double-blind, cross-over trial. Epilepsia 1994; 35(1): 113–21PubMedGoogle Scholar
  133. 133.
    Sander Jr WAS, Patsalos PN, Oxley JR, et al. A randomised double-blind placebo-controlled add-on trial of lamotrigine in patients with severe epilepsy. Epilepsy Res 1990; 6: 221–6PubMedGoogle Scholar
  134. 134.
    Schapel GJ, Beran RG, Vajda FJE, et al. Double-blind, placebo-controlled, crossover study of lamotrigine in treatment-resistant partial seizures. J Neurol Neurosurg Psychiatry 1993; 56: 448–53PubMedGoogle Scholar
  135. 135.
    Smith D, Baker GA, Davies G, et al. Outcomes of add-on treatment with lamotrigine in partial epilepsy. Epilepsia 1993; 34: 312–22PubMedGoogle Scholar
  136. 136.
    Richens A. Safety of lamotrigine. Epilepsia 1994; 35 Suppl. 5: S37–40PubMedGoogle Scholar
  137. 137.
    Committee on Safety of Medicines. Lamotrigine (Lamictal). Curr Probi Pharmacovigilance 1993; 19: 3–4Google Scholar
  138. 138.
    Martin M. Munoz-Blanco JL, Lopez-Ariztegui N. Acute psychosis induced by lamotrigine [abstract]. Epilepsia 1995: 36 Suppl. 3: S118Google Scholar
  139. 139.
    Hennessy MJ, Wiles CM. Lamotrigine encephalopathy [letter]. Lancet 1995; 347: 974–5Google Scholar
  140. 140.
    Kilpatrick ES, Forrest G, Brodie M. Concentration-effect and concentration-toxicity relations with lamotrigine: a prospective study. Epilepsia 1996; 37(6): 534–8PubMedGoogle Scholar
  141. 141.
    Sander JWAS, Trevisol-Bittencourt PC, Hart YM, et al. The efficacy and long term tolcrability of lamotrigine in the treatment of severe epilepsy. Epilepsy Res 1990; 7: 226–9PubMedGoogle Scholar
  142. 142.
    Reife RA. Topiramate. In: Shorvon SD, Dreifuss F, Fish D, et al., editors. The treatment of epilepsy. Oxford: Blackwell Science. 1996. 471–81Google Scholar
  143. 143.
    Topamax data sheet. High Wycombe: Janssen-Cilag, 1996Google Scholar
  144. 144.
    Ahmad SR. Felbamate and aplastic anaemia. Lancet 1994; 344: 463Google Scholar
  145. 145.
    Bebin EM, Sofia RD, Dreifuss FE. Felbamate toxicity. In: Levy RH, Mattson RH, Meldrum BS. editors. Anticpileptic drugs. 4th ed. New York: Raven Press. 1995: 823–7Google Scholar
  146. 146.
    Palmer KJ, McTavish D. Felbamate: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in epilepsy. Drugs 1993; 45(6): 1041–65PubMedGoogle Scholar
  147. 147.
    Wagner ML. Felbamate: a new antiepileptic drug. Am J Hosp Pharm 1994; 51(13): 1657–66PubMedGoogle Scholar
  148. 148.
    Taloxa: safety and tolerability. Taloxa product monograph. Kenilworth (NJ): Schering-Plough, 1995: 28-33Google Scholar
  149. 149.
    Wilder BJ, Campbell KW, Uthman BM, et al. Felbamate for intractable epilepsy: a long term study labstracll. Epilepsia 1991; 32 Suppl. 3: 59Google Scholar
  150. 150.
    Theodore WH, Albert P, Stertz B, et al. Felbamate monotherapy: implications for antiepileptic drug development. Epilepsia 1994; 36(11): 1105–10Google Scholar
  151. 151.
    Knable MB, Rickler K. Psychosis associated with felbamate treatment. J Clin Psychopharmacol 1995; 15(4): 292–3PubMedGoogle Scholar
  152. 152.
    Kanner AM, Ristanovic R, Smith M, et al. Acute depressive disorder following a three week switch-over to felbamate: a controlled study labstractl. Epilepsia 1994; 35 Suppl. 8: 95Google Scholar
  153. 153.
    Hill RR, Stagno SJ, Tesar GE. Secondary mania associated with the use of felbamate. Psychosomatics 1995; 36(4): 404–6PubMedGoogle Scholar
  154. 154.
    King JA. Increased incidence of adverse behavioural side effects associated with the addition of felbamate (FBM) to antiepileptic drug (AED) regimens in the mentally retarded (MR) population [abstract]. Epilepsia 1994; 35 Suppl. 8: 94Google Scholar
  155. 155.
    Bazire S. Psychotropics in problem areas. Psychotropic drug directory. Salisbury: Mark Allen Publishing Ltd. 1995: 91–120Google Scholar
  156. 156.
    Central nervous system. In: British national formulary. London: British Medical Association, Royal Pharmaceutical Society of Great Britain. 1997; 33: 152–223Google Scholar
  157. 157.
    Toone BK, Fenton GW. Epileptic seizures induced by psychotropic drugs. Psychol Med 1977; 7: 265–70PubMedGoogle Scholar
  158. 158.
    Clozaril data sheet. Camberley: Sandoz, 1997Google Scholar
  159. 159.
    Neppe VM, Tucker GJ. Neuropsychiatie aspects of seizure disorders. In: Yudofsky SC, Hales RE, editors. Textbook of neuropsychiatry. 2nd ed. Washington, DC: American Psychiatric Press. 1992: 387–425Google Scholar
  160. 160.
    Richens A, Nawishy S, Trimble M. Antidepressant drugs, convulsions and epilepsy. Br J Clin Pharmacol 1983; 15: 295S–8SPubMedGoogle Scholar
  161. 161.
    Ojemann LM, Friel PN, Trejo WJ, et al. Effect of doxepin on seizure frequency in depressed epileptic patients. Neurology 1983; 33: 646–8PubMedGoogle Scholar
  162. 162.
    Harmant J, Van Rijckevorsel-Harmant K, De Barsy TH, et al. Fluvoxamine: an antidepressant with low (or no) epileptogenic effect [letter]. Lancet 1990; 336: 386PubMedGoogle Scholar
  163. 163.
    Perucca E, Richens A. Interaction between Phenytoin and Imipramine. Br J Clin Pharmacol 1977; 4: 485–6PubMedGoogle Scholar

Copyright information

© Adis International Limited 1997

Authors and Affiliations

  • Ian C. K. Wong
    • 1
  • Simon J. Tavernor
    • 2
  • Rosalyn M. E. Tavernor
    • 3
  1. 1.Department of Pharmacy PracticeUniversity of BradfordBradford, West YorkshireEngland
  2. 2.Academic Department of Psychiatry, Queens Medical CentreUniversity HospitalNottinghamEngland
  3. 3.University Department of PsychiatryRoyal Liverpool University HospitalLiverpoolEngland

Personalised recommendations