Oxcarbazepine in affective and schizoaffective disorders

Anticonvulsants have been successfully used in pharmacopsychiatry after the ir therapeutic value in affective and schizoaffective disorders had been do cumented in several clinical trials. As the authorities in several countrie s registered newer anticonvulsants with fewer side effects, their therapeut ic value in psychiatric disorders was studied. Clinical studies from the ea rly 80's onward have demonstrated the efficacy of oxcarbazepine (OCBZ), a k eto derivative of carbamazepine, in treating mania. in affective and schizo affective disorders. In addition, OCBZ has a distinct pharmacokinetic profi le concerning drug-drug interactions compared to carbamazepine and other an ticonvulsants. Therefore, the value of OCBZ in the treatment of affective a nd schizoaffective disorders needs to be evaluated. We reviewed the literat ure with regard to pharmacokinetic and pharmacodynamic characteristics of O CBZ, drug-drug interactions relevant in pharmacopsychiatry, and the clinica l effects of OCBZ in the treatment of patients with affective and schizoaff ective disorders. According to the literature, OCBZ is regarded as effectiv e in acute mania and appears to reduce the dosage of neuroleptics required for the treatment of affective and schizoaffective disorders. In addition, it has a preferable pharmacokinetic profile with less severe side effects c ompared to carbamazepine and neuroleptics. Furthermore, since OCBZ does not interact substantially with the cytochrome P450 enzyme system, co-ad minis tration with neuroleptics or antidepressants appears to be well tolerated i n affective disorders. However, despite promising effects of OCBZ, few clin ical studies have been published in the last 15 years. We conclude that fur ther studies should validate the efficacy of OCBZ in treating mania and eva luate possible pharmacopsychiatric indications as well as limitations for t his psychotropic compound.