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World J Psychiatry. Apr 19, 2022; 12(4): 580-587
Published online Apr 19, 2022. doi: 10.5498/wjp.v12.i4.580
Effects of antiseizure medications on alternative psychosis and strategies for their application
Yin Yan, Jun-Hong Wu, Xiao-Yan Peng, Xue-Feng Wang
Yin Yan, Jun-Hong Wu, Xiao-Yan Peng, Xue-Feng Wang, Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, Chongqing 400016, China
Author contributions: Yan Y, Wu JH and Peng XY conceived the article and wrote the manuscript; Wang XF reviewed and edited the manuscript; all authors read and approved the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xue-Feng Wang, MD, PhD, Professor, Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Neurology, First Youyi Road, Chongqing 400016, China. xfyp@163.com
Received: May 8, 2021
Peer-review started: May 8, 2021
First decision: July 14, 2021
Revised: August 10, 2021
Accepted: March 14, 2022
Article in press: March 14, 2022
Published online: April 19, 2022
Processing time: 339 Days and 17 Hours
Abstract

Forced normalization (FN) is a unique phenomenon that is often seen in the treatment of epilepsy. FN is characterized by abnormal mental behavior and disordered emotions in epilepsy patients despite a significantly improved electroencephalogram and successful seizure control; the occurrence of FN seriously affects patients’ quality of life. The causes of FN include antiseizure medications (ASMs), epilepsy surgery and vagus nerve stimulation, with ASMs being the most common cause. However, with the timely reduction or discontinuation of ASMs and the use of antipsychotic drugs, the overall prognosis is good. Here, we perform an extensive review of the literature pertaining to FN, including its epidemiology, possible mechanisms, clinical features, treatment and prognosis.

Keywords: Forced normalization, Antiseizure medications, Neurotransmitter, Antipsychotic drugs, Electroshock

Core Tip: Forced normalization (FN) is often seen in the treatment of epilepsy. FN is characterized by abnormal behavior and disordered emotions in epilepsy patients despite a significantly improved electroencephalogram and successful seizure control; the occurrence of FN seriously affects patients’ quality of life. However, with timely recognition and treatment, the overall prognosis is good.