[Pharmacological treatment of psychosis in epilepsy].
Epilepsy is one of the main causes of functional disability, and it is usually associated to psychiatric comorbidity, such as psychosis of epilepsy (POE). POE requires more careful pharmacological treatment, considering the propensity of the antipsychotics (AP) to provoke seizures and the risk of pharmacokinetic interaction with anti-epileptic drugs (AEDs). We discussed the classification and the main types of POE, as well as some characteristics of AP typical and atypical, its potential to decrease the epileptogenic threshold (ET) and possible interactions between AP and AED. Atypical AP, except clozapine, disclosed smaller influence on ET than typical AP. Regarding pharmacokinetic interactions, AEDs are related with a significant increase of the AP metabolism. Therefore, in spite of the risk for AP induced convulsions be dose-dependent, higher doses of AP can be necessary in the treatment of POE.
Guarnieri
Ricardo
R
Centro de Cirurgia de Epilepsia, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil. ricardoguarnieri@uol.com.br
Hallak
Jaime Eduardo Cecílio
JE
Walz
Roger
R
Velasco
Tonicarlo Rodrigues
TR
Alexandre Júnior
Veriano
V
Terra-Bustamante
Vera Cristina
VC
Wichert-Ana
Lauro
L
Sakamoto
Américo Ceiki
AC
D000927:Anticonvulsants / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D004347:Drug Interactions; D004827:Epilepsy / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D011618:Psychotic Disorders / Q000145:classification / Q000188:drug therapy* / Q000209:etiology
D000927:Anticonvulsants; D014150:Antipsychotic Agents