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BACKGROUND: There is an increasing interest in the treatment of psychiatric symptoms with anticonvulsants, especially in the treatment of refractory patients. It is questionable whether or not the efficacy of anticonvulsants as psychotropic drugs is sufficiently verified. AIM: To examine the efficacy ofanticonvulsants based on the available studies. Possible indications considered are aggression, anxiety, psychosis and alcohol and cocaine withdrawal symptoms. METHOD: Relevant literature is derivedfor the period between 1966 till now from Medline, Embase, the Cochrane Library and PsycInfo, using as key words anticonvulsants, antiepileptics, carbamazepine, (sodium)valproate, valproic acid, divalproex, clonazepam, oxcarbazepine, lamotrigine, vigabatrin, topiramate, gabapentin, phenytoin, diphenylhydantoin, mental disorders, epilepsy, affective disorders and trials. RESULs: Forty-six studies were included, which explored the efficacy of carbamazepine, clonazepam, phenytoin, gabapentin and valproic acid. The efficacy of carbamazepine in the treatment of aggression and of clonazepam in the treatment of the panic disorder are sufficientty verified. The additional value of carbamazepine and valproic acidfor alcohol withdrawal is the increased rate of improvement. In the treatment of psychosis there is some evidence for the efficacy of anticonvulsants, especially as suppleraentary treatraent. CONCLUSIONS: Carbamazepine is effective in the treatment of aggression and alcohol withdrawal. Clonazepam is effective in the treatment of the panic disorder. Concerning the other applications, there are indicationsfor the efficacy of anticonvulsants. Additional research is needed to obtain more evidence for the support of these applications.

BACKGROUND: There is an increasing interest in the treatment of psychiatric symptoms with anticonvulsants, especially in the treatment of refractory patients. It is questionable whether or not the efficacy of anticonvulsants as psychotropic drugs is sufficiently verified. AIM: To examine the efficacy ofanticonvulsants based on the available studies. Possible indications considered are aggression, anxiety, psychosis and alcohol and cocaine withdrawal symptoms. METHOD: Relevant literature is derivedfor the period between 1966 till now from Medline, Embase, the Cochrane Library and PsycInfo, using as key words anticonvulsants, antiepileptics, carbamazepine, (sodium)valproate, valproic acid, divalproex, clonazepam, oxcarbazepine, lamotrigine, vigabatrin, topiramate, gabapentin, phenytoin, diphenylhydantoin, mental disorders, epilepsy, affective disorders and trials. RESULs: Forty-six studies were included, which explored the efficacy of carbamazepine, clonazepam, phenytoin, gabapentin and valproic acid. The efficacy of carbamazepine in the treatment of aggression and of clonazepam in the treatment of the panic disorder are sufficientty verified. The additional value of carbamazepine and valproic acidfor alcohol withdrawal is the increased rate of improvement. In the treatment of psychosis there is some evidence for the efficacy of anticonvulsants, especially as suppleraentary treatraent. CONCLUSIONS: Carbamazepine is effective in the treatment of aggression and alcohol withdrawal. Clonazepam is effective in the treatment of the panic disorder. Concerning the other applications, there are indicationsfor the efficacy of anticonvulsants. Additional research is needed to obtain more evidence for the support of these applications.

A 23-year-old woman with a history of episodic stiffening of the limbs since her early adolescence, reported attacks of muscle contraction accompanied by feelings of panic but without loss of consciousness. Epileptic seizures, e.g. progressive myoclonic epilepsy, metabolic encephalopathy, dystonia and tetany were suggested. During the examination, muscle contraction could be provoked whilst measuring the blood pressure. Tetany based on primary hypoparathyroidism was diagnosed from the medical history as well as the neurological examination. This was confirmed by laboratory tests. She was successfully treated with calcium and I-alpha-(OH)2 vitamin D3.