Blank R
Klinik für Kinder- und Jugendpsychiatrie der Philipps-Universität Marburg.
Fortschr Neurol Psychiatr. 1990 Jan;58(1):19-32. doi: 10.1055/s-2007-1001167.
In a review of more than 200 studies over the last three decades, the manifold psychic effects of anticonvulsives on healthy persons, on patients with and without epilepsy, on patients with mental disorders with or without cerebral damages are analysed and summarized. The following results are mainly shown: 1. Carbamazepine: a positive effect on "expansive" behaviour and mood can be observed in about 50-60% of the patients. The cognitive and psychomotor performance is almost unchanged. 2. Valproinate: Negative psychic effects can rarely be seen for a longer time (exception: reversible encephalopathy). The behaviour can similarly be influenced as with carbamazepine. 3. Phenytoin: Cognitive and psychomotor performance is negatively influenced. The effects on behaviour are contradictory. 4. Phenobarbitone and Primidone: Diverse negative effects on performance and behaviour, especially as "expansive" disorders in children and adolescents, seemed to be proven. 5. Ethosuximide: Beside the drug specific provocation of psychotic disorders, both, positive and negative effects on behaviour and cognitive functions are discussed. 6. The psychic effects of other anticonvulsives such as Benzodiazepines, Sulthiame and Pheneturide are shortly summarized. 7. Polytherapy: Negative influences on psychic functions are significant. Finally the results are discussed concerning their clinical relevance.
在对过去三十年里200多项研究的综述中，分析并总结了抗惊厥药对健康人、癫痫患者与非癫痫患者、有或无脑损伤的精神障碍患者的多种心理影响。主要呈现了以下结果：1. 卡马西平：约50%至60%的患者可观察到对“欣快”行为和情绪有积极影响。认知和精神运动表现几乎未变。2. 丙戊酸盐：长时间内很少见负面心理影响（例外情况：可逆性脑病）。其对行为的影响与卡马西平类似。3. 苯妥英：认知和精神运动表现受到负面影响。对行为的影响存在矛盾之处。4. 苯巴比妥和扑米酮：对表现和行为有多种负面影响，尤其是对儿童和青少年的“欣快”障碍，似乎已得到证实。5. 乙琥胺：除了药物特异性引发精神障碍外，还讨论了其对行为和认知功能的正负两方面影响。6. 简要总结了其他抗惊厥药如苯二氮䓬类、舒噻美和苯乙肼的心理影响。7. 联合治疗：对心理功能有显著负面影响。最后讨论了这些结果的临床相关性。
