Antiseizure medication-induced obsessive-compulsive disorder and tic disorder: a pragmatic review

ABSTRACT

Introduction

With a lifetime prevalence of 2.3%, obsessive compulsive disorder is a chronic, disabling condition that is associated with significant social and occupational impairment. Up to 30% of individuals with obsessive-compulsive disorder have a lifetime diagnosis of tic disorders. Antiseizure medication is increasingly used for a variety of physical and psychiatric illnesses. Clarification of the relationship between these symptoms/disorders and use of antiseizure medication is critically important for diagnostic and treatment purposes.

Areas covered

Studies on antiseizure-induced obsessive-compulsive disorder and tic disorders are reviewed. The literature search strategy identified 89 articles. Twenty-nine articles were included in the final results. Of these, 24 are case reports or case studies, 2 cross-sectional studies, 1 chart review, 1 population-based case-control study and 1 observational prospective study assessing lamotrigine, levetiracetam, topiramate, zonisamide, and carbamazepine.

Expert opinion

This study highlighted the temporal relationship of antiseizure medication use and onset of obsessive-compulsive symptoms and tics. Monitoring for medication-induced obsessive compulsions or tics should be undertaken when prescribing antiseizure medication for treatment of mood disorders or epilepsy. Further research identifying the causal relationship between antiseizure medication and de novo onset of obsessive-compulsive symptoms, obsessive-compulsive disorder and tic disorder is required.

KEYWORDS:

• Anticonvulsant
• bipolar disorder
• epilepsy
• seizure disorder
• obsessions
• compulsions
• obsess-compulsive disorder
• tics
• medication-induced

Article highlights

• Antiseizure medication is associated with emergence of obsessions, compulsions, and tics in some patients

• Monitoring for obsessions, compulsions, or tics should be undertaken during treatment with antiseizure medication

Acknowledgments

The authors thank Elizabeth Russell, Librarian at Parkwood Institute, London, Ontario, Canada for her assistance with the literature search.

Declaration of interest

V Sharma reports personal fees from the Neuroscience Education Institute and grants from Assurex, Genome Canada, Sage Therapeutics, Stanley Medical Research Institute, and Sunovion Pharmaceuticals, and participation on the advisory boards for Sunovion Pharmaceuticals and Otsuka, outside the submitted work. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was funded by the Mach-Gaenslen Foundation.