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Barbiturate anticonvulsants in refractory affective disorders
1Department of Psychiatry, University of Southern California School of Medicine.
Summary
This study found primidone and mephobarbital, often overlooked anticonvulsants, showed positive psychotropic effects in seizure-free patients with affective illness. These findings challenge previous assumptions about barbiturates and their mood-stabilizing potential.
Area of Science:
- Neuroscience
- Psychopharmacology
- Clinical Psychiatry
Background:
- Valproate and carbamazepine show positive psychotropic effects.
- Phenytoin remains controversial; barbiturates have poor psychotropic reputation.
- Limited research exists on primidone and mephobarbital for affective disorders.
Purpose of the Study:
- To investigate the psychotropic effects of primidone and mephobarbital.
- To analyze effects on illness severity and affective cycle rate.
- To evaluate these agents in patients with treatment-resistant affective illness.
Main Methods:
- Retrospective analysis of 27 seizure-free patients with affective illness.
- Patients received trials of primidone and/or mephobarbital.
- Assessed effects on affective state, psychotic symptoms, and cycle rate over up to four years.
Main Results:
- 33% of patients showed sustained positive effects with primidone.
- 11% showed positive effects with mephobarbital after primidone failure.
- 15% had brief positive effects; 41% had no or negative effects.
Conclusions:
- Primidone and mephobarbital demonstrate unexpected positive psychotropic effects.
- These findings challenge the general perception of barbiturates.
- Further research is warranted on their therapeutic potential in affective disorders.