Posted by ed_uk on July 31, 2005, at 16:37:25
In reply to Schizophrenia: a new treatment option........, posted by ed_uk on July 30, 2005, at 16:28:57
HA! Since it appears that no one is interested in schizophrenia, I was wondering whether allopurinol might be useful in the treatment of bipolar disorder.
In patients with schizophrenia, allopurinol was apparantly effective (as an 'add on' to APs) in controlling positive symptoms such as hallucinations, delusions and paranoia. Might allopurinol be an effective treatment for psychosis associated with bipolar disorder???? ....including psychotic depression, psychotic mania, and mixed episodes.
Allopurinol is an old anti-gout drug. It's very cheap and is extremely widely used. Although it's usually well-tolerated, serious hypersensitivity reactions occasionally occur....... a bit like Lamictal really!
Allopurinol inhibits an enzyme called xanthine oxidase. Xanthine oxidase inhibition prevents the formation of uric acid. As a result, allopurinol is used to prevent recurrent attacks of gout.
The Iranian study stated that.......
'There is a large amount of data showing that adenosine plays a role opposite to dopamine in the brain. Adenosine agonists and antagonists produce behavioral effects similar to dopamine antagonists and dopamine agonists, respectively. Allopurinol, a well-known hypouricemic drug that inhibits xanthine oxidase, has been used as an add-on drug in the treatment of poorly responsive schizophrenic patients. Indeed, the neuropsychiatric effects of allopurinol in schizophrenia have been suggested to be secondary to its inhibitory effect of purine degradation, enhancing adenosinergic activity.'
If allopurinol really does act as an indirect adenosine agonist, one might expect it to cause drowsiness........ caffeine, a mild stimulant, is thought to exert most of its effects via adenosine antagonism. Indeed, drowsiness has been reported as a side effect of allopurinol.
Caffeine can sometimes aggravate anxiety, especially panic disorder. I wonder whether allopurinol might be an effective treatment for panic disorder??? .........especially in those patients who react badly to caffeine. Patients who respond well to caffeine might dislike allopurinol. Just a theory.....
Caffeine, a convulsant, can aggravate epilepsy. Allopurinol appears to be useful in the treatment of epilepsy......... (further evidence that allopurinol affects the CNS)....
Epilepsia. 1991 Mar-Apr;32(2):279-83.
Clinical effects of allopurinol on intractable epilepsy.
Tada H, Morooka K, Arimoto K, Matsuo T.
First Department of Pediatrics, Toho University School of Medicine, Tokyo, Japan.
We studied the clinical efficacy of allopurinol as add-on therapy in 31 patients with intractable epilepsy. When administered for a short time, allopurinol was effective in 17 patients (55%); 8 were seizure-free, 8 had 75% decrease in seizure frequency, and 1 had greater than 50% decrease. Allopurinol was most effective in patients with localization-related epilepsy, especially in secondarily generalized tonic-clonic seizures. Allopurinol was not as effective in patients with Lennox syndrome or West syndrome, or in severe myoclonic epilepsy in infants. When allopurinol was administered greater than 1 year, its initial effectiveness continued in 8 of 14 patients who exhibited initial improvement. In 2 of the remaining 6 patients, the initial improvement disappeared during the course of treatment but control was regained by increasing the dosage of allopurinol. Mild side effects were observed in 4 patients (13%): drowsiness in 3 and abdominal pain in 1. Allopurinol may be a useful antiepileptic drug (AED), and a double-blind placebo-controlled trial should be performed.
~Ed
poster:ed_uk
thread:535711
URL: http://www.dr-bob.org/babble/20050728/msgs/536043.html