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Lamotrigine use in geriatric patients with bipolar depression
Matthew Robillard1, David K Conn
1Baycrest Centre for Geriatric Care, Department of Psychiatry, 3560 Bathurst Street, Toronto, ON M6A 2E1. mrobillard@baycrest.org
Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie
|November 8, 2002
Summary
Adding lamotrigine to lithium and valproate treatment showed effectiveness in geriatric patients with bipolar disorder (BD) during depression. This combination therapy helped reduce symptoms and prevent rehospitalization in the study group.
Area of Science:
- Geriatric Psychiatry
- Pharmacology
- Mood Disorders
Background:
- Bipolar disorder (BD) in geriatric patients presents unique treatment challenges, particularly during depressive episodes.
- Existing treatments like lithium and valproate may require augmentation for optimal efficacy in this population.
Purpose of the Study:
- To evaluate the effectiveness of adjunctive lamotrigine in elderly inpatients with bipolar disorder (BD) experiencing depression.
- To assess the impact of adding lamotrigine to established lithium and valproate regimens.
Main Methods:
- A small cohort of geriatric patients with BD (depressed phase) on lithium and valproate were treated with escalating doses of lamotrigine (75-100 mg/day).
- Treatment efficacy was assessed using clinical interviews and the Hamilton Depression Rating Scale (HDRS) at 6 weeks.
- Remission was defined as a ≥50% reduction in HDRS scores.
Main Results:
- Three out of five elderly female patients with BD achieved symptom remission (≥50% HDRS reduction).
- These patients remained stable and out of hospital at 3-month follow-up.
- Lamotrigine was generally well-tolerated, with one patient experiencing manageable hand tremor.
Conclusions:
- Adjunctive lamotrigine appears to be a potentially effective treatment option for geriatric patients with bipolar depression on lithium and valproate.
- Further research with larger sample sizes is warranted to confirm these findings.