Predictive value of isolated epileptiform discharges for a favorable therapeutic response to antiepileptic drugs in nonepileptic psychiatric patients.
The efficacy of antiepileptic drugs (AEDs) in treating behavioral symptoms in nonepileptic psychiatric patients with abnormal EEGs is currently unknown. Although isolated epileptiform discharges have been reported in many psychiatric conditions, they are most commonly observed in patients with aggression, panic, or autistic spectrum disorders. The literature search was guided by 3 criteria: (1) studies had patients who did not experience seizures, (2) patients had EEGs, and (3) an AED was administered. Most important finding is that the number of "controlled" studies was extremely small. Overall, most reports suggest that the use of an AED can be associated with clinical and, at times, improved EEG abnormalities. Additionally, six controlled studies were found for other psychiatric disorders, such as learning disabilities with similar results. Overall, the use of anticonvulsants to treat nonepileptic psychiatric patients needs further controlled studies to better define indications, adequate EEG work-up, best AED to be used, and optimal durations of treatment attempts.
*University of Missouri in Kansas City, Department of Psychiatry and Neurosciences, Kansas City, MO, U.S.A.; †Rutgers University, State University of New Jersey, New Brunswick, New Jersey, U.S.A.; ‡Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University of Munich, Munich, Germany; and §Clinic for Psychiatry and Psychotherapy, Charité University Medicine, St. Hedwig-Krankenhaus, Berlin, Germany.
Nash N
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Boutros
Sandra B
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Kirollos
Oliver
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Pogarell
Jürgen
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Gallinat
D000927:Anticonvulsants / Q000627:therapeutic use*; D004569:Electroencephalography / Q000187:drug effects*; D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy* / Q000503:physiopathology*; D011237:Predictive Value of Tests
D000927:Anticonvulsants