CARBAMAZEPINE CO-TREATMENT IN SCHIZOPHREN IA

Very few controlled clinical trials have been assessing the interactio n of antipsychotics and antiepileptics. However, schizophrenic patient s frequently receive a combination therapy consisting of haloperidol a nd carbamazepine. The data for this treatment strategy are contradicto ry and may depend on the initial plasma concentration of the antipsych otic. There is convincing evidence that after addition of carbamazepin e the plasma concentration of neuroleptics drops due to hepatic enzyme induction. In this study, we treated 18 schizophrenic patients either with haloperidol alone or in combination with carbamazepine. The use of carbamazepine was associated with a dramatic fall in haloperidol pl asma levels and a worse clinical outcome compared to the monotherapy g roup. These results, together with a review of the literature, lead us to the conclusion that there are no obvious advantages of carbamazepi ne co-medication in schizophrenia compared to an optimized neuroleptic monotherapy.