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From Innovative Psychopharmacotherapy

Overview: Carbamazepine, Limbic and Kindling, and Nonresponsive Psychosis

Vernon M. Neppe

The iminostilbene anticonvulsant, carbamazepine, is being increasingly used in the treatment of nonepileptic psychiatric patients. It is also the prime limbic antikindling agent in experimental animals. This chapter explores the links of carbamazepine, kindling. anticonvulsant action, and nonresponsive psychosis. There is a growing but still limited evidence for its usefulness in both the prophylaxis and treatment of affective illness and in nonresponsive psychosis. It has also been used, in uncontrolled studies, to manage nonpsychotic dyscontrol; additionally, there is preliminary evidence for its use in a wide spectrum of other conditions, e.g., post-traumatic stress disorder; difficulties in self-control; histories of non-addictive, hallucinogen-induced or hallucinogen-mobilizing psychoses; and possible underlying temporolimbic instability. Theoretical and empirical evidence suggest that carbamazepine has both psychotropic and limbic antikindling effects. The speculation of possible kindling in humans as being responsible for certain psychopathology leads to possible links with related chemical kindling-like experiences. for which the term 'chindling" is suggested. The varying epileptogenicities of neuroleptics and of antidepressants are discussed in the context of the possibility that certain psychoses - may be resistant to treatment because of underlying kindling.

Keywords

Anti-kindling agents - Carbamazepine - Chindling - Dyscontrol - Hallucinogen - Kindling - Nonresponsive psychosis - Psychotropic effects - Schizophreniform illness - Structural relationships - Temporal lobe abnormality

 

 

 

 


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