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Case Study Mania and Neuropsychiatric Excitation Following Carbamazepine

1988; Elsevier BV; Volume: 27; Issue: 4 Linguagem: Inglês

10.1097/00004583-198807000-00021

1527-5418

Richard R. Pleak, Boris Birmaher, ANTIGONI GAVRILESCU, CHANDRA ABICHANDANI, Daniel T. Williams,

Bipolar Disorder and Treatment

As part of clinical trials and an ongoing protocol evaluating the benefit of carbamazepine (CBZ) as a treatment for aggression in inpatient children and adolescents, six boys (aged 10 to 16 years) were found to develop adverse behavioral and neurological reactions. While on CBZ, one adolescent became manic (first report of CBZ-induced mania in an adolescent); one developed hypomania; two showed increased irritability, impulsivity, hyperactivity, and aggression; one developed an abnormal EEG with sharp waves and spikes; and one had the first recurrence in years of absence seizures. Various mechanisms for these seemingly paradoxical effects are discussed, including a "switch" process similar to other tricyclics, and CNS excitation. Use of CBZ for psychiatric problems in children and adolescents should be accompanied by careful observation for adverse effects. J. Am. Acad. Child Adolesc. Psychiatry, 1988, 27, 4:500–503.