Use of antiepileptic mood stabilizers in dermatology.

Abstract

Several antiepileptic drugs (AEDs) are approved by the US Food and Drug Administration for the treatment of bipolar disorder (valproic acid, divalproex, lamotrigine, carbamazepine) and some cutaneous neuropathic pain syndromes (carbamazepine, gabapentin, pregabalin). The AEDs may be effective in the management of (1) chronic pruritus, including pruritus due systemic disease, including uremia, neuropathic pain, neuropathic pruritus, and complex cutaneous sensory syndromes, especially where central nervous system (CNS) sensitization plays a role; (2) management of emotional dysregulation and the resultant repetitive self-excoriation or other cutaneous self-injury in patients who repetitively stimulate or manipulate their integument to regulate emotions (prurigo nodularis, lichen simplex chronicus, skin picking disorder, trichotillomania); (3) management of dermatologic clinical manifestations associated with autonomic nervous system activation (hyperhidrosis, urticaria, flushing; these often occur in conjunction with psychiatric disorders with prominent autonomic activation and dysregulation, eg, social anxiety disorder, posttraumatic stress disorder); and (4) when certain anticonvulsants have a direct therapeutic effect (eg, in psoriasis); currently the use of AEDs for such cases is largely experimental. Gabapentin (dosage range 300-3600 mg daily) is the most widely studied AED mood stabilizer in dermatology and is especially effective in situations where CNS sensitization is a mediating factor. Further larger-scale controlled studies of AEDs in dermatology are necessary.

• Authors: Madhulika A Gupta, Daiana R Pur, Branka Vujcic, Aditya K Gupta
• Journal: Clinics in dermatology (Clin Dermatol) 2018 Nov - Dec Vol. 36 Issue 6 Pg. 756-764 ISSN: 1879-1131 [Electronic] United States
• PMID: 30446200 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2018 Elsevier Inc. All rights reserved.

Chemical References

• Anticonvulsants
• Pregabalin
• Gabapentin
• Lamotrigine

Topics

• Anticonvulsants (therapeutic use)
• Gabapentin (therapeutic use)
• Humans
• Hyperhidrosis (drug therapy)
• Lamotrigine (therapeutic use)
• Neuralgia (drug therapy)
• Pregabalin (therapeutic use)
• Pruritus (drug therapy, etiology)
• Sensation Disorders (drug therapy)
• Skin Diseases (drug therapy)
• Trichotillomania (drug therapy)