Frequency of and rationales for the combined use of electroconvulsive therapy and antiepileptic drugs in Austria and the literature.
Our aim was to observe the frequency of combination therapy using antiepileptic drugs (AEDs) and electroconvulsive therapy (ECT) in Austria and the literature, and to provide rationales and recommendations based on clinical and molecular properties. The responsible ECT leaders of eight Austrian departments were contacted for information about combination therapy. A computerized PubMed database search was performed and supplemented by cross-referencing from papers, review articles and psychiatric manuals. The frequency of combination therapy in Austrian departments ranges between 0 and 85.7%. In 17 studies enrolling a total of 189 patients, 87 (46.0%) patients received combination therapy. Of these 87 patients, nine (10.3%) reported adverse effects. ECT and AEDs show overlapping clinical and molecular properties. Combination therapy is an observed reality and, according to the currently available literature, feasible. A comparison of clinical and molecular properties indicates possible augmentative effects, making combination therapy a promising alternative in treatment-resistant cases. But there is still a clear need for prospective case controlled data concerning side effects, safety profiles and effectiveness until it can be recommended.
Rubner
Paul
P
Department of Neurology, Regional Hospital of Rankweil 1, Rankweil, Austria. paul.rubner@lkhr.at
Koppi
Stefan
S
Conca
Andreas
A
D000927:Anticonvulsants / Q000627:therapeutic use*; D001317:Austria / Q000453:epidemiology; D001714:Bipolar Disorder / Q000188:drug therapy / Q000453:epidemiology* / Q000628:therapy*; D002220:Carbamazepine / Q000031:analogs & derivatives / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D004565:Electroconvulsive Therapy / Q000379:methods* / Q000706:statistics & numerical data*; D017408:Guidelines as Topic; D006801:Humans; D000077213:Lamotrigine; D016651:Lithium Carbonate / Q000627:therapeutic use; D000078330:Oxcarbazepine; D016896:Treatment Outcome; D014227:Triazines / Q000627:therapeutic use; D014635:Valproic Acid / Q000627:therapeutic use
D000927:Anticonvulsants; D014227:Triazines; D016651:Lithium Carbonate; D002220:Carbamazepine; D014635:Valproic Acid; D000077213:Lamotrigine; D000078330:Oxcarbazepine