Carbamazepine treatment of schizophrenia

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William T. carpenter,Jr., M.D.*, Rose Kurz, Ph.D., Brian Kirkpatrick,M.D., Thmms Hanlon, FLD., Robert Buchanan,M.D., Royce Waltrip, M.D., Alan E%reie.r, M.D. MarylandPsychiatricResearch Center, P.O. Box 21247, E?alti.mm,MD

21228

Carbamazepinehasbeenpraposedasanalternativeto neurolepticsinthe treatment of schizophrenia. If proven efficacious,carbamazepinewculd pmvide a basis for new hypotheses for the pathophysiologyof schizophrenia. Theoretical support forthisideacomes fromsimilarities in-of partial cuqlexseizures at-dschizophreniaandtheefficacyofcaxkmmzepine inatypical affectivedisorders, includk~thosewithpsy&otic manifestations. lkerearerepmtsofclinicalixtpmvemmtonantiseizu~ n&icationofschizo#mmicpatients incasestudiesaxx3 inprovementin a few schizqrhrenia cases includedincontmlledstudies. 'NmQ-seven schizophrenicpatients (RLYJ. arkiEM-III-R) wxe randanly assignedtoadcuble-blindparallel gmupdesigntotesttheefficacyof caK&mazepinevs. placebo inpreventingrelapse in stablecutpatimts withdrawnfmn neurolepticmedication. Atrelapseorcmpletionof 41umths instudy,p&i.mtswemcrossed over, pmviding furtherdescriptivedata rqardmg efficacy. Data analysis fails to support carbamazepineefficacy. Ihepmportionof relapsed patients ark3days to relapse tended to favor placebo over carbamazepine,pmvidirq substantialstatisticalpmer inrejectingthe hypothesisof CartwMzepine superiority. EpiscdicdysamtmlphenmeMdid notcorrelatewithtreatmentresponse,andasmalltreatmentresponsive subgmupdidnotemerge.Findingsareg eneralizedto patients with &runic, relapsingschizo@renia.