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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