Antiepileptic Drugs to Treat Psychiatric Disorders [ Active ]

Preface

Antiepileptic drugs (AEDs) are increasingly being used in conditions other than epilepsy. Their most common area of ‘‘off label'' use is in psychiatric and neuropsychiatric disorders. Indeed, several AEDs, namely, divalproex sodium, lamotrigine, and carbamazepine, have United States Food and Drug Administration indications for treating various phases of bipolar disorder. These drugs are now viewed as major treatments for bipolar disorder, with new AEDs often evaluated as potential mood-stabilizing agents.

However, it has become evident that anticonvulsant properties do not automatically predict antimanic or mood-stabilizing effects and that many AEDs have beneficial psychotropic properties, whether or not they have efficacy in bipolar disorder. Thus, while some anticonvulsants may have antimanic or moodstabilizing effects, others may have anxiolytic, anticraving, or weight-loss properties. Controlled trials that have been conducted suggest that divalproex sodium, lamotrigine, and topiramate may have beneficial effects when used adjunctively with antipsychotics in schizophrenia; that pregabalin may reduce anxiety in generalized anxiety disorder; that topiramate may reduce alcohol and cocaine craving and use in substance use disorders; and that topiramate and zonisamide may have therapeutic effects on eating pathology and weight in eating disorders. These properties need to be properly ‘‘profiled'' so that they can be used to benefit patients and further advance neuropsychopharmacology research.

Despite the increased clinical use and research with these compounds, the diverse therapeutic effects of AEDs in psychiatric and neuropsychiatric conditions has not been gathered and scrutinized in one source for many years. This book provides an accessible and expert summary of currently available AEDs and their use in these disorders for the mental health professional. The first part of the book (chaps. 1–6) reviews available AEDs, their putative mechanisms of action in epilepsy and other neurological conditions in which they are commonly used (e.g., neuropathic pain and migraine), their use in epilepsy and neuropsychiatric disorders often accompanied by seizures and psychopathology (e.g., traumatic brain injury, autism, and intellectual disability), and their side effects and drug-drug interactions. The second part of the book (chaps. 7–20) is devoted to providing a state-of-the-art update on the use of AEDs in a broad range of psychiatric disorders and disorders with psychiatric features. Specifically, AEDs in the treatment of bipolar and major depressive disorder, schizophrenia, anxiety disorders, substance use disorders, eating and weight disorders, impulse control disorders, personality disorders, sleep disorders, and fibromyalgia are reviewed and summarized. The third part of the book (chap. 21) discusses the mechanisms of action of currently available AEDs potentially underlying their therapeutic properties in psychiatric conditions, with a focus on mood disorders.

Altogether, this book provides a resource for clinicians who treat patients with psychiatric and neuropsychiatric conditions and for researchers studying the expanding role of AEDs in neuropsychopharmacology.