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Carbamazepine for treatment-resistant melancholia
M Cullen1, P Mitchell, H Brodaty
1Mood Disorders Unit, Prince Henry Hospital, Sydney, Australia.
Background:
There have only been a few studies of the role of carbamazepine in the management of treatment-resistant depression.
Method:
The response to carbamazepine of 16 melancholic patients, who had been depressed for an extended period despite a number of standard treatments, was studied retrospectively.
Results:
Seven patients (44%) had a moderate or marked improvement. The responders included both psychotic and nonpsychotic depressives, and patients with concurrent organic brain disease. There was, however, a high rate of complications, with 5 of these 7 responders (71%) having to discontinue carbamazepine because of adverse effects. This high rate of complications may have reflected the older age of our sample.
Conclusion:
These findings suggest the efficacy of carbamazepine in melancholic patients who have not responded to conventional treatments, but indicate that the high rate of significant side effects may limit its long-term usefulness.