Response of carbamzepine in bipolar disorder: kindlers versus non-kindlers

Based on carbamazepine's hypothesized ability to stabilize temporal lobe seizures and behavioral disorders and its ability to inhibit limbic system excitability in models such as kindling, we undertook this study with the aims of finding out the response of carbamazepine in kindler and non kindler groups and to see the relationship of socio-demographic and clinical variables in kindler and non-kindler bipolar mood disorder with response to carbamazepine. Simple random sampling was done and patients (over a period of one and a half year) between 18-50 years who had a diagnosis of Bipolar Affective Disorder, current episode mania as per lCD-10 and who had history of at least three manic or depressive episode in the past were taken. The total sample was divided into two groups i. e. kindler and non-kindlers. Kindlers were defined as patients with 3 or more affective episodes in less than equal to 1 year apart. Non-kindlers were defined as patients with at least 3 episodes in the past with inter episodic period of more than 1 year. All the patients included in this study were followed up for 6 months and were given carbamazepine in adequate dosages. Fifty -five patients completed the 6 months follow up. Results showed that there was no significant difference between the two groups based on sex, past history of substance intake, type of mood (irritable versus elated), number of relapses during the follow-up and improvement on carbamazepine. Our study does not support the kindling hypothesis.