Antiepileptic drugs to treat psychiatric disorders

Abstract

This book delves into the role of antiepileptics in psychiatric and neuro-psychiatric disorders which happen to be their most common area of “off label” use. We often associate antiepileptics with mood stabilization but we seemed not to realize that there are various other therapeutic benefits of this class of drugs as highlighted by the editors in the preface. This book has 3 parts to it and there are numerous contributors to each chapter in each part and the contributors are all preeminent experts in psychiatry. The first part provides an overview of antiepileptics and its various uses in neuropsychiatric conditions. It contains one chapter that describes briefly the mechanism of action of these drugs as well as a summary about the first and second generation antiepileptics such as Felbamate, Topiramate, Gabapentin, Zonisamide, Pregabalin just to name a few. The author had also provided some information about the latest antiepileptics in the pipeline as well. The second part consists of chapters describing antiepileptics in psychiatric disorders. It is made up of 10 chapters. The first chapter in described the treatment of acute manic and mixed episodes. This chapter highlights all the commonly prescribed antiepileptics in manic and mixed episodes with tabulated supporting evidence from randomized controlled trials which provides an excellent guide to those looking for evidence based literature with regards to this. This will be an important chapter especially for postgraduates as it provides useful information about drugs such as Oxcarbazepine, Phenytoin, Topiramate, Gabapentin as well as Lamotrigine as these are not commonly used in our clinical practice for manic or mixed episodes. The second chapter in part 2 talks about the role of antiepileptics in long-term treatment of bipolar disorder. This is also an important aspect of bipolar disorder as we know that long-term management involves a complex and arduous process that can be very challenging even to the most experienced psychiatrist. Adequate evidence for safety, maintenance efficacy and practical guidelines for long-term use in bipolar disorder is presented in this chapter for all approved antiepileptics as well as those for which clear evidence indicates that they have secondary roles in bipolar disorder.