Drug Safety

, Volume 24, Issue 7, pp 513–536

Behavioural Effects of the New Anticonvulsants

Review Article

Abstract

Of the 9 new anticonvulsants that have been marketed recently in the UK or US, a number appear to have either adverse or beneficial effects on behaviour. There is now a considerable database of information, in terms of the number of patients treated and/or the number of published reports, on vigabatrin, lamotrigine, gabapentin and topiramate. Oxcarbazepine has been available in some centres for several years and there is extensive experience with the drug in Scandinavia. It appears that the profile of adverse and beneficial effects is similar to that of carbamazepine.

Behavioural effects have probably been greatest with vigabatrin, with psychosis, depression and other behavioural problems recorded, but the use of this drug has been limited because of the concern about visual field constriction. The cognitive and behavioural effects of topiramate have caused concern, but these may be much less of a problem if lower starting dosages and escalation rates are used. Psychosis and depression have been associated with topiramate, as they have with another carbonic anhydrase inhibiting drug, zonisamide. Although zonisamide has been used for many years in Japan and Korea, experience elsewhere with this drug is currently very limited. Gabapentin seems to be less associated with adverse behavioural effects than some of the other new anticonvulsant drugs. The reports of behavioural disturbance with gabapentin in children may be related to dose escalation. Behavioural disturbance as a direct result of lamotrigine seems to be uncommon, although indirect effects on behaviour, through the so-called ‘release phenomenon’ from improved seizure control and consequent ability to misbehave, can occur.

Positive behavioural effects have been described with several of the new anticonvulsants, particularly gabapentin, lamotrigine and oxcarbazepine; all of these drugs may have mood-levelling effects that could be of value in treating affective disorders. The information on tiagabine and levetiracetam is too limited to allow any firm conclusions to be drawn with regard to positive or negative behavioural effects.

When interpreting reports of behavioural changes with anticonvulsants, it is important to avoid attributing the effect to the drug when one or more of the other multiple causes of behavioural disturbance in people with epilepsy may be responsible or when an indirect effect such as ‘forced normalisation’ may be the cause. Many of the published studies are retrospective and unblinded rather than double-blind, placebo-controlled, prospective trials, implying that much of the data must be interpreted with caution at this stage.

References

  1. 1.
    de Silva M, MacArdle B, McGowan M, et al. Randomised comparative monotherapy trial of phenobarbitone, phenytoin, carbamazepine, or sodium valproate for newly diagnosed childhood epilepsy. Lancet 1996; 347: 709–13PubMedCrossRefGoogle Scholar
  2. 2.
    Pal DK, Das T, Chaudhury G, et al. Randomised controlled trial to assess acceptability of phenobarbital for childhood epilepsy in rural India. Lancet 1998; 351: 19–23PubMedCrossRefGoogle Scholar
  3. 3.
    Mackay FJ, Wilton LV, Pearce GL, et al. Safety of long-term lamotrigine in epilepsy. Epilepsia 1997; 38: 881–6PubMedCrossRefGoogle Scholar
  4. 4.
    Besag FMC. Epilepsy, learning, and behavior in childhood. Epilepsia 1995; 36Suppl. 1: S58–S63PubMedCrossRefGoogle Scholar
  5. 5.
    McClelland HA. Psychiatric disorders. In: Davies DM, editor. Textbook of adverse drug reactions. Oxford: Oxford University Press, 1991: 549–77Google Scholar
  6. 6.
    Wong ICK, Tavernor SJ, Tavernor RME. Psychiatric adverse effects of anticonvulsant drugs: incidence and therapeutic implications. CNS Drugs 1997; 8: 492–509CrossRefGoogle Scholar
  7. 7.
    Alvarez N, Besag F, Iivanainen M. Use of antiepileptic drugs in the treatment of epilepsy in people with intellectual disability. J Intell Disabil Res 1998; 42Suppl. 1: 1–15Google Scholar
  8. 8.
    Trimble MR. Anticonvulsant-induced psychiatric disorders. The role of forced normalisation. Drug Saf 1996; 15: 159–66PubMedCrossRefGoogle Scholar
  9. 9.
    Logsdail SJ, Toone BK. Post-ictal psychoses: a clinical and phenomenological description. Br J Psychiatry 1988; 152: 246–52PubMedCrossRefGoogle Scholar
  10. 10.
    Besag FM. The therapeutic dilemma: treating subtle seizures or indulging in electroencephalogram cosmetics? Semin Pediatr Neurol 1995; 2: 261–8PubMedCrossRefGoogle Scholar
  11. 11.
    Holtkamp M, Pfeiffer M, Buchheim K, et al. Tiagabine and non-convulsive status epilepticus [in German]. Nervenarzt 1999; 70: 1104–6PubMedCrossRefGoogle Scholar
  12. 12.
    Ettinger AB, Bernal OG, Andriola MR, et al. Two cases of nonconvulsive status epilepticus in association with tiagabine therapy. Epilepsia 1999; 40: 1159–62PubMedCrossRefGoogle Scholar
  13. 13.
    Knake S, Hamer HM, Schomburg U, et al. Tiagabine-induced absence status in idiopathic generalized epilepsy. Seizure 1999; 8: 314–7PubMedCrossRefGoogle Scholar
  14. 14.
    Eckardt KM, Steinhoff BJ. Nonconvulsive status epilepticus in two patients receiving tiagabine treatment. Epilepsia 1998; 39: 671–4PubMedCrossRefGoogle Scholar
  15. 15.
    Schapel G, Chadwick D. Tiagabine and non-convulsive status epilepticus. Seizure 1996; 5: 153–6PubMedGoogle Scholar
  16. 16.
    Besag FM. Lamotrigine in the treatment of epilepsy in people with intellectual disability. J Intell Disabil Res 1998; 42Suppl. 1: 50–6Google Scholar
  17. 17.
    Besag FM, Berry DJ, Pool F, et al. Carbamazepine toxicity with lamotrigine: pharmacokinetic or pharmacodynamic interaction? Epilepsia 1998; 39: 183–7PubMedCrossRefGoogle Scholar
  18. 18.
    Sander JW, Hart YM. Vigabatrin and behaviour disturbances [letter]. Lancet 1990; 335: 57PubMedCrossRefGoogle Scholar
  19. 19.
    Sander JW, Hart YM, Trimble MR, et al. Vigabatrin and psychosis. J Neurol Neurosurg Psychiatry 1991; 54: 435–9PubMedCrossRefGoogle Scholar
  20. 20.
    Betts T, Thomas L. Vigabatrin and behaviour disturbances. Lancet 1990; 335: 605–6Google Scholar
  21. 21.
    Dam M. Vigabatrin and behaviour disturbances [letter]. Lancet 1990; 335: 605CrossRefGoogle Scholar
  22. 22.
    Thomas L, Trimble M, Schmitz B, et al. Vigabatrin and behaviour disorders: a retrospective survey. Epilepsy Res 1996; 25: 21–7PubMedCrossRefGoogle Scholar
  23. 23.
    Levinson DF, Devinsky O. Psychiatric adverse events during vigabatrin therapy. Neurology 1999; 53: 1503–11PubMedCrossRefGoogle Scholar
  24. 24.
    Cockerell OC, Moriarty J, Trimble M, et al. Acute psychological disorders in patients with epilepsy: a nationwide study. Epilepsy Res 1996; 25(2): 119–31PubMedCrossRefGoogle Scholar
  25. 25.
    Robinson MK, Richens A, Oxley R. Vigabatrin and behaviour disturbances [letter]. Lancet 1990; 336: 504PubMedCrossRefGoogle Scholar
  26. 26.
    Ring HA, Reynolds EH. Vigabatrin and behavioural disturbances [letter]. Lancet 1990; 335: 970PubMedCrossRefGoogle Scholar
  27. 27.
    Brodie MJ, McKee PJW. Vigabatrin and psychosis [letter]. Lancet 1990; 335: 1279PubMedCrossRefGoogle Scholar
  28. 28.
    Veggiotti P, De Agostini G, Muzio C, et al. Vigabatrin use in psychotic epileptic patients: report of a prospective pilot study. Acta Neurol Scand 1999; 99: 142–6PubMedCrossRefGoogle Scholar
  29. 29.
    Caviedes BE, Herranz JL, Arteaga R, et al. In children with refractory epilepsy: vigabatrin or lamotrigine? [in Spanish]. Revista de Neurol 1999; 28: 444–8Google Scholar
  30. 30.
    Canovas MA, Ordovas Baines JP, Beltran MM, et al. Vigabatrin-associated reversible acute psychosis in a child. Ann Pharmacother 1995; 29: 1115–7Google Scholar
  31. 31.
    Ring HA, Crellin R, Kirker S, et al. Vigabatrin and depression. J Neurol Neurosurg Psychiatry 1993; 56: 925–8PubMedCrossRefGoogle Scholar
  32. 32.
    Ferrie CD, Robinson RO, Panayiotopoulos CP. Psychotic and severe behavioural reactions with vigabatrin: a review. Acta Neurol Scand 1996; 93: 1–8PubMedCrossRefGoogle Scholar
  33. 33.
    Sheth RD, Buckley D, Penney S, et al. Vigabatrin in childhood epilepsy: comparable efficacy for generalized and partial seizures. Clin Neuropharmacol 1996; 19: 297–304PubMedCrossRefGoogle Scholar
  34. 34.
    Wallace SJ. A comparative review of the adverse effects of anticonvulsants in children with epilepsy. Drug Saf 1996; 15: 378–93PubMedCrossRefGoogle Scholar
  35. 35.
    Dulac O, Chiron C, Luna D, et al. Vigabatrin in childhood epilepsy. J Child Neurol 1991; Suppl. 2: S30–S7PubMedGoogle Scholar
  36. 36.
    Appleton RE. The role of vigabatrin in the management of infantile epileptic syndromes. Neurology 1993; 43: S21–S3PubMedCrossRefGoogle Scholar
  37. 37.
    Guberman A. Vigabatrin. Can J Neurol Sci 1996; 23: S13–S7PubMedGoogle Scholar
  38. 38.
    Wong IC. Retrospective study of vigabatrin and psychiatric behavioural disturbances. Epilepsy Res 1995; 21: 227–30PubMedCrossRefGoogle Scholar
  39. 39.
    Schmidt D. Behavioural abnormalities and retention rates of anti-epilepsy drugs during long-term treatment of epilepsy: a clinical perspective. Acta Neurol Scand 1995; Suppl. 162: S7–S10Google Scholar
  40. 40.
    Jawad S, Clarke E, Richens A. Vigabatrin-induced psychosis—management problems. Seizure 1994; 3: 309–10PubMedCrossRefGoogle Scholar
  41. 41.
    Chiaretti A, Castorina M, Tortorolo L, et al. Acute psychosis and vigabatrin in childhood [in Italian]. Pediatria Med Chirurgica 1994; 16: 489–90Google Scholar
  42. 42.
    van der Zwan Jr A, van der Zwan A. Vigabatrin: results with a new antiepileptic agents in 57 patients in a general neurological practice [in Dutch]. Ned Tijdschr Geneeskd 1994; 138: 1859–63PubMedGoogle Scholar
  43. 43.
    Naumann M, Supprian T, Kornhuber J, et al. Bipolar affective psychosis after vigabatrin [letter]. Lancet 1994; 343: 606–7PubMedCrossRefGoogle Scholar
  44. 44.
    Tartara A, Manni R, Galimberti CA, et al. Six-year follow-up study on the efficacy and safety of vigabatrin in patients with epilepsy. Acta Neurol Scand 1992; 86: 247–51PubMedCrossRefGoogle Scholar
  45. 45.
    Sabers A, Gram L. Pharmacology of vigabatrin. Pharmacol Toxicol 1992; 70: 237–43PubMedCrossRefGoogle Scholar
  46. 46.
    Staples CI, King MA, Boyle RS. Acute psychosis after withdrawal of vigabatrin [letter]. Med J Aust 1992; 156: 291PubMedGoogle Scholar
  47. 47.
    Ylinen A. Antiepileptic efficacy of vigabatrin in people with severe epilepsy and intellectual disability. J Intell Disabil Res 1998; 42Suppl. 1: 46–9Google Scholar
  48. 48.
    Provinciali L, Bartolini M, Mari F, et al. Influence of vigabatrin on cognitive performances and behaviour in patients with drug-resistant epilepsy. Acta Neurol Scand 1996; 94: 12–8PubMedCrossRefGoogle Scholar
  49. 49.
    Ring HA, Trimble MR, Costa DC, et al. Effect of vigabatrin on striatal dopamine receptors: evidence in humans for interactions of GABA and dopamine systems. J Neurol Neurosurg Psychiatry 1992; 55: 758–61PubMedCrossRefGoogle Scholar
  50. 50.
    Eke T, Talbot JF, Lawden MC. Severe persistent visual field constriction associated with vigabatrin. BMJ 1997; 314: 180–1PubMedCrossRefGoogle Scholar
  51. 51.
    Harding GF. Severe persistent visual field constriction associated with vigabatrin. Benefit: risk ratio must be calculated for individual patients [letter]. BMJ 1998; 316: 232–3PubMedCrossRefGoogle Scholar
  52. 52.
    Vanhatalo S, Paakkonen L, Nousiainen I. Visual field constriction in children treated with vigabatrin. [Published erratum appears in Neurology 2000 Jan 11; 54 (1): 277]. Neurology 1999; 52: 1713–4PubMedCrossRefGoogle Scholar
  53. 53.
    Committee on Safety of Medicines. Vigabatrin (Sabril): visual field defects. Curr Probl Pharmacovigilance 1999; 25: 13Google Scholar
  54. 54.
    Data on file, Glaxo Wellcome, 2000Google Scholar
  55. 55.
    Crawford P. An audit of topiramate use in a general neurology clinic. Seizure 1998; 7: 207–11PubMedCrossRefGoogle Scholar
  56. 56.
    Martin M, Munnoz-Blanco JL, Lopez-Ariztegui N, et al. Acute psychosis induced by lamotrigine [abstract]. Epilepsia 1995; 36Suppl. 3: S118Google Scholar
  57. 57.
    Polselli GM, Pennisi EM, Talamanca F, et al. Psychotic disorder after lamotrigine. Ital J Neurol Sci 1998; 19: 124–5PubMedCrossRefGoogle Scholar
  58. 58.
    Coppola G, Pascotto A. Lamotrigine as add-on drug in children and adolescents with refractory epilepsy and mental delay: an open trial. Brain Dev 1997; 19: 398–402PubMedCrossRefGoogle Scholar
  59. 59.
    Ettinger AB, Weisbrot DM, Saracco J, et al. Positive and negative psychotropic effects of lamotrigine in patients with epilepsy and mental retardation. Epilepsia 1998; 39: 874–7PubMedCrossRefGoogle Scholar
  60. 60.
    Beran RG, Gibson RJ. Aggressive behaviour in intellectually challenged patients with epilepsy treated with lamotrigine. Epilepsia 1998; 39: 280–2PubMedCrossRefGoogle Scholar
  61. 61.
    Botts SR, Raskind J. Gabapentin and lamotrigine in bipolar disorder. Am J Health Syst Pharm 1999; 56: 1939–44PubMedGoogle Scholar
  62. 62.
    Suppes T, Brown ES, McElroy SL, et al. Lamotrigine for the treatment of bipolar disorder: a clinical case series. J Affect Disord 1999; 53: 95–8PubMedCrossRefGoogle Scholar
  63. 63.
    Bowden CL, Calabrese JR, McElroy SL, et al. The efficacy of lamotrigine in rapid cycling and non-rapid cycling patients with bipolar disorder. Biol Psychiatry 1999; 45: 953–8PubMedCrossRefGoogle Scholar
  64. 64.
    Calabrese JR, Bowden CL, Sachs GS, et al. A double-blind placebo-controlled study of lamotrigine monotherapy in outpatients with bipolar I depression. Lamictal 602 Study Group. J Clin Psychiatry 1999; 60: 79–88PubMedCrossRefGoogle Scholar
  65. 65.
    Fatemi SH, Rapport DJ, Calabrese JR, et al. Lamotrigine in rapid-cycling bipolar disorder. J Clin Psychiatry 1997; 58: 522–7PubMedCrossRefGoogle Scholar
  66. 66.
    Kusumakar V, Yatham LN. An open study of lamotrigine in refractory bipolar depression. Psychiatry Res 1997; 72: 145–8PubMedCrossRefGoogle Scholar
  67. 67.
    Erfurth A, Walden J, Grunze H. Lamotrigine in the treatment of schizoaffective disorder. Neuropsychobiology 1998; 38: 204–5PubMedCrossRefGoogle Scholar
  68. 68.
    Davanzo PA, King BH. Open trial lamotrigine in the treatment of self-injurious behavior in an adolescent with profound mental retardation. J Child Adolesc Psychopharmacol 1996; 6: 273–9PubMedCrossRefGoogle Scholar
  69. 69.
    Smith D, Baker G, Davies G, et al. Outcomes of add-on treatment with lamotrigine in partial epilepsy. Epilepsia 1993; 34: 312–22PubMedCrossRefGoogle Scholar
  70. 70.
    Gillham R, Baker G, Thompson P, et al. Standardisation of a self-report questionnaire for use in evaluating cognitive, affective and behavioural side-effects of anti-epileptic drug treatments. Epilepsy Res 1996; 24: 47–55PubMedCrossRefGoogle Scholar
  71. 71.
    De Leon OA, Furmaga KM. Effect of lamotrigine treatment in epileptic psychosis [letter]. J Clin Psychopharmacol 1999; 19: 186–8PubMedCrossRefGoogle Scholar
  72. 72.
    Uvebrant P, Bauziene R. Intractable epilepsy in children. The efficacy of lamotrigine treatment, including non-seizurerelated benefits. Neuropediatrics 1994; 25: 284–9PubMedCrossRefGoogle Scholar
  73. 73.
    Besag FM, Wallace SJ, Dulac O, et al. Lamotrigine for the treatment of epilepsy in childhood. J Pediatr 1995; 127: 991–7PubMedCrossRefGoogle Scholar
  74. 74.
    Besag FM, Dulac O, Alving J, et al. Long-term safety and efficacy of lamotrigine (Lamictal) in paediatric patients with epilepsy. Seizure 1997; 6: 51–6PubMedCrossRefGoogle Scholar
  75. 75.
    Fowler M, Besag F, Pool F. Effects of lamotrigine on behaviour in children [abstract]. Epilepsia 1994; 35Suppl. 7: 69Google Scholar
  76. 76.
    Buchanan N. The efficacy of lamotrigine on seizure control in 34 children, adolescents and young adults with intellectual and physical disability. Seizure 1995; 4: 233–6PubMedCrossRefGoogle Scholar
  77. 77.
    Mullens L, Gallagher J, Manasco P. Improved neurological function accompanies effective control of the Lennox-Gastaut syndrome with Lamictal: results of a multinational, placebo-controlled trial [abstract]. Epilepsia 1996; 37: 163Google Scholar
  78. 78.
    Jacoby A, Baker G, Bryant Comstock L, et al. Lamotrigine add-on therapy is associated with improvement in mood in patients with severe epilepsy [abstract]. Epilepsia 1996; 37Suppl. 5: 42Google Scholar
  79. 79.
    Anand A, Charney DS, Oren DA, et al. Attenuation of the neuropsychiatric effects of ketamine with lamotrigine: support for hyperglutamatergic effects of N-methyl-D-aspartate receptor antagonists. Arch Gen Psychiatry 2000; 57: 270–6PubMedCrossRefGoogle Scholar
  80. 80.
    Short C, Cooke L. Hypomania induced by gabapentin [letter]. Br J Psychiatry 1995; 166: 679–80PubMedCrossRefGoogle Scholar
  81. 81.
    Hauck A, Bhaumik S. Hypomania induced by gabapentin [letter]. Br J Psychiatry 1995; 167: 549PubMedCrossRefGoogle Scholar
  82. 82.
    Leweke FM, Bauer J, Elger CE. Manic episode due to gabapentin treatment [letter]. Br J Psychiatry 1999; 175: 291PubMedCrossRefGoogle Scholar
  83. 83.
    Doherty KP, Gates JR, Panovich PE, et al. Gabapentin in a medically refractory epilepsy population: seizure response and unusual side effects [abstract]. Epilepsia 1995; 36Suppl. 4: 71Google Scholar
  84. 84.
    Morris GL. Gabapentin. Epilepsia 1999; 40Suppl. 5: S63–S70PubMedCrossRefGoogle Scholar
  85. 85.
    Holmes GL. Gabapentin for treatment of epilepsy in children. Semin Pediatr Neurol 1997; 4: 244–50PubMedCrossRefGoogle Scholar
  86. 86.
    Mikati MA, Choueri R, Khurana DS, et al. Gabapentin in the treatment of refractory partial epilepsy in children with intellectual disability. J Intell Disabil Res 1998; 42Suppl. 1: 57–62Google Scholar
  87. 87.
    Khurana DS, Riviello J, Helmers S, et al. Efficacy of gabapentin therapy in children with refractory partial seizures. J Pediatr 1996; 128: 829–33PubMedCrossRefGoogle Scholar
  88. 88.
    Tallian KB, Nahata MC, Lo W, et al. Gabapentin associated with aggressive behavior in pediatric patients with seizures. Epilepsia 1996; 37: 501–2PubMedCrossRefGoogle Scholar
  89. 89.
    Lee DO, Steingard RJ, Cesena M, et al. Behavioral side effects of gabapentin in children. Epilepsia 1996; 37: 87–90PubMedCrossRefGoogle Scholar
  90. 90.
    Wolf SM, Shinnar S, Kang H, et al. Gabapentin toxicity in children manifesting as behavioral changes. Epilepsia 1995; 36: 1203–5PubMedCrossRefGoogle Scholar
  91. 91.
    Besag FMC. Gabapentin use with paediatric patients. Rev Contemp Pharmacother 1996; 7: 233–8Google Scholar
  92. 92.
    Sokolski KN, Green C, Maris DE, et al. Gabapentin as an adjunct to standard mood stabilizers in outpatients with mixed bipolar symptomatology. Ann Clin Psychiatry 1999; 11: 217–22PubMedGoogle Scholar
  93. 93.
    Perugi G, Toni C, Ruffolo G, et al. Clinical experience using adjunctive gabapentin in treatment-resistant bipolar mixed states. Pharmacopsychiatry 1999; 32: 136–41PubMedCrossRefGoogle Scholar
  94. 94.
    Hatzimanolis J, Lykouras L, Oulis P, et al. Gabapentin asmonotherapy in the treatment of acute mania. Eur Neuropsychopharmacol 1999; 9: 257–8PubMedCrossRefGoogle Scholar
  95. 95.
    Cabras PL, Hardoy MJ, Hardoy MC, et al. Clinical experience with gabapentin in patients with bipolar or schizoaffective disorder: results of an open-label study. J Clin Psychiatry 1999; 60: 245–8PubMedCrossRefGoogle Scholar
  96. 96.
    Young LT, Robb JC, Hasey GM, et al. Gabapentin as an adjunctive treatment in bipolar disorder. J Affect Disord 1999; 55: 73–7PubMedCrossRefGoogle Scholar
  97. 97.
    Erfurth A, Kammerer C, Grunze H, et al. An open label study of gabapentin in the treatment of acute mania. J Psychiatr Res 1998; 32: 261–4PubMedCrossRefGoogle Scholar
  98. 98.
    Maurer I, Volz HP, Sauer H. Gabapentin leads to remission of somatoform pain disorder with major depression. Pharmacopsychiatry 1999; 32: 255–7PubMedCrossRefGoogle Scholar
  99. 99.
    Hardoy MC, Hardoy MJ, Carta MG, et al. Gabapentin as a promising treatment for antipsychotic-induced movement disorders in schizoaffective and bipolar patients. J Affect Disord 1999; 54: 315–7PubMedCrossRefGoogle Scholar
  100. 100.
    Brown ES, Hong SC. Antidepressant-induced bruxism successfully treated with gabapentin. J Am Dent Assoc 1999; 130: 1467–9PubMedGoogle Scholar
  101. 101.
    Harden CL, Lazar LM, Pick LH, et al. A beneficial effect on mood in partial epilepsy patients treated with gabapentin. Epilepsia 1999; 40: 1129–34PubMedCrossRefGoogle Scholar
  102. 102.
    Trimble MR, Rusch N, Betts T, et al. Psychiatric symptoms after therapy with new antiepileptic drugs: psychopathological and seizure related variables. Seizure 2000; 9: 249–54PubMedCrossRefGoogle Scholar
  103. 103.
    Kellett MW, Smith DF, Stockton PA, et al. Topiramate in clinical practice: first year’s postlicensing experience in a specialist epilepsy clinic. J Neurol Neurosurg Psychiatry 1999; 66: 759–63PubMedCrossRefGoogle Scholar
  104. 104.
    Betts T, Smith K, Khan G. Severe psychiatric reactions to topiramate [abstract]. Epilepsia 1995; 38: 64Google Scholar
  105. 105.
    Khan A, Faught E, Gilliam F, et al. Acute psychotic symptoms induced by topiramate. Seizure 1999; 8: 235–7PubMedCrossRefGoogle Scholar
  106. 106.
    Bittermann HJ, Steinhoff BJ. Topiramate: an effective new anticonvulsant. An open prospective study [in German]. Nervenarzt 1997; 68: 836–8PubMedCrossRefGoogle Scholar
  107. 107.
    Tartara A, Sartori I, Manni R, et al. Efficacy and safety of topiramate in refractory epilepsy: a long-term prospective trial. Ital J Neurol Sci 1996; 17: 429–32PubMedCrossRefGoogle Scholar
  108. 108.
    Fowler M, Besag FMC, Strange M, et al. Effects of topiramate on behaviour in adolescents with learning disability [abstract]. Epilepsia 1997; 38: 131Google Scholar
  109. 109.
    Marcotte D. Use of topiramate, a new anti-epileptic as a mood stabilizer. J Affect Disord 1998; 50: 245–51PubMedCrossRefGoogle Scholar
  110. 110.
    Normann C, Langosch J, Schaerer LO, et al. Treatment of acute maniawith topiramate [letter]. Am J Psychiatry 1999; 156: 2014PubMedGoogle Scholar
  111. 111.
    Leach JP, Brodie MJ. Tiagabine. Lancet 1998; 351: 203–7PubMedCrossRefGoogle Scholar
  112. 112.
    Leppik IE. Tiagabine: the safety landscape. Epilepsia 1995; 36Suppl. 6: S10–S3PubMedCrossRefGoogle Scholar
  113. 113.
    Adkins JC, Noble S. Tiagabine: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential in the management of epilepsy. Drugs 1998; 55: 437–60PubMedCrossRefGoogle Scholar
  114. 114.
    Kalviainen R. Tiagabine: a new therapeutic option for people with intellectual disability and partial epilepsy. J Intell Disabil Res 1998; 42Suppl. 1: S63–S7Google Scholar
  115. 115.
    Pita-Calandre E. Clinical implications of pharmacology and pharmacokinetics of tiagabine [in Spanish]. Rev Neurol 1999; 28: 337–9PubMedGoogle Scholar
  116. 116.
    Uthman BM, Rowan AJ, Ahmann PA, et al. Tiagabine for complex partial seizures: a randomized, add-on, dose-response trial. Arch Neurol 1998; 55: 56–62PubMedCrossRefGoogle Scholar
  117. 117.
    Dodrill CB, Arnett JL, Sommerville KW, et al. Cognitive and quality of life effects of differing dosages of tiagabine in epilepsy. Neurology 1997; 48: 1025–31PubMedCrossRefGoogle Scholar
  118. 118.
    Sveinbjornsdottir S, Sander JW, Patsalos PN, et al. Neuropsychological effects of tiagabine, a potential new antiepileptic drug. Seizure 1994; 3: 29–35PubMedCrossRefGoogle Scholar
  119. 119.
    Kaufman KR. Adjunctive tiagabine treatment of psychiatric disorders: three cases. Ann Clin Psychiatry 1998; 10: 181–4PubMedGoogle Scholar
  120. 120.
    Grunze H, Erfurth A, Marcuse A, et al. Tiagabine appears not to be efficacious in the treatment of acute mania. J Clin Psychiatry 1999; 60: 759–62PubMedCrossRefGoogle Scholar
  121. 121.
    Ketter TA, Post RM, Theodore WH. Positive and negative psychiatric effects of antiepileptic drugs in patients with seizure disorders. Neurology 1999; 53: S53–S67PubMedGoogle Scholar
  122. 122.
    Hagenah U, Coners H, Kotlarek F, et al. Tuberous sclerosis and organic bipolar disorder in a 15-year-old adolescent [in German]. Z Kinder Jugendpsychiatr 1999; 27: 283–9CrossRefGoogle Scholar
  123. 123.
    Emrich HM. Studies with oxcarbazepine (Trileptal) in acute mania. Int Clin Psychopharmacol 1990; 5: 83–8CrossRefGoogle Scholar
  124. 124.
    Emrich HM, Altmann H, Dose M, et al. Therapeutic effects of GABA-ergic drugs in affective disorders. A preliminary report. Pharmacol Biochem Behav 1983; 19: 369–72PubMedCrossRefGoogle Scholar
  125. 125.
    Wildgrube C. Case studies of prophylactic long-term effects of oxcarbazepine in recurrent affective disorders. Int Clin Psychopharmacol 1990; 5: 89–94Google Scholar
  126. 126.
    Grant SM, Faulds D. Oxcarbazepine: a review of its pharmacology and therapeutic potential in epilepsy, trigeminal neuralgia and affective disorders. Drugs 1992; 43: 873–88PubMedCrossRefGoogle Scholar
  127. 127.
    Müller A. Oxcarbazepine in acute mania. In: Pichot P, Berner P, Wolf R, et al., editors. Proceedings of the VII World Congress of Psychiatry. Psychiatry: the state of the art. 3. Pharmacopsychiatry. Vol. 83. New York: Plenum Press, 1983: 495–500Google Scholar
  128. 128.
    Knable MB, Rickler K. Psychosis associated with felbamate treatment [letter]. J Clin Psychopharmacol 1995; 15: 292–3PubMedCrossRefGoogle Scholar
  129. 129.
    Theodore WH, Albert P, Stertz B, et al. Felbamate monotherapy: implications for antiepileptic drug development. Epilepsia 1995; 36: 1105–10PubMedCrossRefGoogle Scholar
  130. 130.
    McConnell H, Snyder PJ, Duffy JD, et al. Neuropsychiatric side effects related to treatment with felbamate. J Neuropsychiatr Clin Neurosci 1996; 8: 341–6Google Scholar
  131. 131.
    Hill RR, Stagno SJ, Tesar GE. Secondarymania associated with the use of felbamate. Psychosomatics 1995; 36: 404–6PubMedCrossRefGoogle Scholar
  132. 132.
    Li LM, Nashef L, Moriarty J, et al. Felbamate as add-on therapy. Eur Neurol 1996; 36: 146–8PubMedCrossRefGoogle Scholar
  133. 133.
    Ketter TA, Malow BA, Flamini R, et al. Felbamate monotherapy has stimulant-like effects in patients with epilepsy. Epilepsy Res 1996; 23: 129–37PubMedCrossRefGoogle Scholar
  134. 134.
    Gay PE, Mecham GF, Coskey JS, et al. Behavioral effects of felbamate in childhood epileptic encephalopathy (Lennox-Gastaut syndrome). Psychol Rep 1995; 77: 1208–10PubMedCrossRefGoogle Scholar
  135. 135.
    Bauer J, Elger CE. Anticonvulsive drug therapy. Historical and current aspects [in German]. Nervenarzt 1995; 66: 403–11PubMedGoogle Scholar
  136. 136.
    Miyamoto T, Kohsaka M, Koyama T. Psychotic episodes during zonisamide treatment. Seizure 2000; 9: 65–70PubMedCrossRefGoogle Scholar
  137. 137.
    Murai T, Kubota Y, Sengoku A. Unknown people believed to be known: the ‘assoziierende Erinnerungs-falschungen’ by Kraepelin. Psychopathology 2000; 33: 52–4PubMedCrossRefGoogle Scholar
  138. 138.
    Matsuura M, Trimble MR. Zonisamide and psychosis. J Epilepsy 1997; 10: 52–4CrossRefGoogle Scholar
  139. 139.
    Ono T, Yagi K, Seino M. Clinical efficacy and safety of new antiepileptics: zonisamide [in Japanese]. Seishin-Igaku 1988; 30: 482Google Scholar
  140. 140.
    Kawasaki J, Sengoku A, Kanemoto K, et al. The occurrence of acute paranoid-hallucinatory state in epilepsy - in association with antiepileptic drugs [in Japanese]. Seishin-Igaku 1991; 33: 595–600Google Scholar
  141. 141.
    Matsuura M, Senzaki A, Okubo Y, et al. Eight epileptic patients showing delusional-hallucinatory state during zonisamide administration [in Japanese]. Seishin-Igaku 1993; 35: 413–9CrossRefGoogle Scholar
  142. 142.
    Hara S, Imasaka Y, Takei S, et al. Five cases of zonisamide-related psychosis: with particular reference to the drug interaction between zonisamide and phenytoin and to the risk factors for epileptic psychosis [in Japanese]. Jpn J Psychiatric Ther 1993; 1993: 59–64Google Scholar
  143. 143.
    Mayahara K, Kanemoto K, Kawasaki J, et al. Zonisamide and epileptic psychosis. J Jpn Epilepsy Soc 1995; 13: 177–83Google Scholar
  144. 144.
    Charles CL, Stoesz L, Tollefson G. Zonisamide-induced mania. Psychosomatics 1990; 31: 214–7PubMedCrossRefGoogle Scholar
  145. 145.
    Data on file, Elan Pharmaceuticals, 2000Google Scholar
  146. 146.
    Kimura S. Zonisamide-induced behavior disorder in two children. Epilepsia 1994; 35: 403–5PubMedCrossRefGoogle Scholar
  147. 147.
    Ozawa H, Sasaki M, Sugai K, et al. Acase of behavior disorder with gait and sleep disturbances induced by zonisamide [in Japanese]. Brain Dev 1995; 27: 496–8Google Scholar
  148. 148.
    Kanba S, Yagi G, Kamijima K, et al. The first open study of zonisamide, a novel anticonvulsant, shows efficacy in mania. Prog Neuro-Psychopharmacol Biol Psychiatry 1994; 18: 707–15CrossRefGoogle Scholar
  149. 149.
    Levetiracetam. Data on file, UCB Pharma, 2000Google Scholar
  150. 150.
    Kasteleijn-Nolst Trenite DG, Marescaux C, Stodieck S, et al. Photosensitive epilepsy: a model to study the effects of antiepileptic drugs. Evaluation of the piracetam analogue, levetiracetam. Epilepsy Res 1996 Nov; 25(3): 225–30PubMedCrossRefGoogle Scholar

Copyright information

© Adis International Limited 2001

Authors and Affiliations

  1. 1.St Piers Lingfield, Lingfield, Surrey and Institute of Epileptology, London, England and Bedfordshire and Luton Community NHS Trust, Twinwoods Health Resource CentreBedfordshireEngland

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