Allopurinol for Treatment-Resistant Schizophrenia and Epilepsy: A Case Report

Although allopurinol is conventionally used to treat hyperuricemia, available evidence supports its potential benefit as an adjunctive medication not only for schizophrenia [3] but also for epilepsy [9]. Schizophrenic patients are prone to seizures because of comorbid substance abuse, long-term exposure to psychotropic agents that may lower their seizure threshold, or frequent episodes of head injury [5]. Similarly, individuals with epilepsy have a ∼2.5 times higher risk of being diagnosed with schizophrenia [8]. Although the relationship between schizophrenia and epilepsy remains controversial, both conditions share several common features, such as ventricular enlargement, temporal lobe pathology, neuropsychology, and genetic factors [2]. However, few reports focus on therapeutic strategies for schizophrenic patients with epilepsy. Here, we present a case of treatment-resistant schizophrenia presenting with post-traumatic epilepsy as a sequel of subdural hemorrhage (SDH). The patient's positive symptoms and seizure attacks were significantly improved after allopurinol augmentation.

References

• 1 Brundege JM, Dunwiddie TV. Role of adenosine as a modulator of synaptic activity in the central nervous system.  Adv Pharmacol. 1997;  39 353-391
• 2 Cascella NG, Schretlen DJ, Sawa A. Schizophrenia and epilepsy: is there a shared susceptibility?.  Neurosci Res. 2009;  63 227-235
• 3 Dickerson FB, Stallings CR, Origoni AE. et al . A double-blind trial of adjunctive allopurinol for schizophrenia.  Schizophr Res. 2009;  109 66-69
• 4 Dunwiddie TV, Masino SA. The role and regulation of adenosine in the central nervous system.  Annu Rev Neurosci. 2001;  24 31-55
• 5 Hyde TM, Weinberger DR. Seizures and schizophrenia.  Schizophr Bull. 1997;  23 611-622
• 6 Iqbal MM, Rahman A, Husain Z. et al . Clozapine: a clinical review of adverse effects and management.  Ann Clin Psychiatry. 2003;  15 33-48
• 7 Lara DR, Dall’Igna OP, Ghisolfi ES. et al . Involvement of adenosine in the neurobiology of schizophrenia and its therapeutic implications.  Prog Neuropsychopharmacol Biol Psychiatry. 2006;  30 617-629
• 8 Qin P, Xu H, Laursen TM. et al . Risk for schizophrenia and schizophrenia-like psychosis among patients with epilepsy: population based cohort study.  Br Med J. 2005;  331 23
• 9 Togha M, Akhondzadeh S, Motamedi M. et al . Allopurinol as adjunctive therapy in intractable epilepsy: a double-blind and placebo-controlled trial.  Arch Med Res. 2007;  38 313-316

Correspondence