Anticonvulsants for the treatment of behavioral and psychological symptoms of dementia: a literature review.
OBJECTIVE
To review and summarize the currently available data on the use of anticonvulsant mood stabilizers (carbamazepine, valproic acid, gabapentin, lamotrigine, topiramate) in the treatment of behavioral and psychological symptoms of dementia (BPSD); to determine whether these medications can be recommended for routine clinical use.


METHODS
Literature search in five databases (PubMed, MEDLINE, EMBASE, PsychINFO and COCHRANE collaboration) and analysis of the randomized controlled double-blinded clinical trials found therein.


RESULTS
A total of seven RCTs were identified (two for carbamazepine and five for valproate). One study showed statistically significant improvement of BPSD in the medication group in comparison to the placebo group; five studies showed no significant differences; one study showed statistically significant worsening of the symptoms in the medication group vs. placebo. The majority of the studies reported significantly more frequent adverse effects in the medication group.


CONCLUSIONS
Although clearly beneficial in some patients, anticonvulsant mood stabilizers cannot be recommended for routine use in the treatment of BPSD at the present time.
Department of Psychiatry, Yale University School of Medicine, New Haven, U.S.A.
Sergiy
S
Konovalov
Sunanda
S
Muralee
Rajesh R
RR
Tampi
D000374:Aggression / Q000523:psychology*; D000588:Amines / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use*; D002220:Carbamazepine / Q000627:therapeutic use; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D003704:Dementia / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology; D000077206:Gabapentin; D006801:Humans; D000077213:Lamotrigine; D009483:Neuropsychological Tests; D011596:Psychomotor Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D014227:Triazines / Q000627:therapeutic use; D014635:Valproic Acid / Q000627:therapeutic use; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use
D000588:Amines; D000927:Anticonvulsants; D003509:Cyclohexanecarboxylic Acids; D014227:Triazines; D002220:Carbamazepine; D005680:gamma-Aminobutyric Acid; D014635:Valproic Acid; D000077206:Gabapentin; D000077213:Lamotrigine