Mood disorders in the psychoneurologic borderland: three cases of responsiveness to carbamazepine.
Three patients with affective disorders with psychotic features were refractory to various combinations of psychotropic agents (antipsychotics, antidepressants, and lithium). Closer scrutiny revealed a seizure history in two patients and unusual neuropsychiatric features in the third patient. Subsequent substitution of carbamazepine for the antipsychotic resulted in control of the patients' psychoses. The authors describe clinical features that may identify the patient who may respond to carbamazepine. The mechanism of carbamazepine's psychotropic effects through its hypothesized ability to inhibit limbic system kindling is discussed. The case reports emphasize the need for careful neuropsychiatric assessment of patients who are refractory to conventional treatments.
Kessler
A J
AJ
Department of Psychiatry, University of Wisconsin Medical School, Madison 53792.
Barklage
N E
NE
Jefferson
J W
JW
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy*; D002220:Carbamazepine / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D004833:Epilepsy, Temporal Lobe / Q000150:complications* / Q000188:drug therapy; D004830:Epilepsy, Tonic-Clonic / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D019965:Neurocognitive Disorders / Q000188:drug therapy*
D000927:Anticonvulsants; D002220:Carbamazepine