[Prediction of response to lamotrigine treatment in bipolar outpatients: a multicentric, 6-month, prospective,...

In case of a major depressive episode it is crucial to establish whether this is a depressive episode in the course of a bipolar I or bipolar II disorder or a "true" unipolar major depression which is possible through screening for lifetime manic or hypomanic episodes and can be facilitated by the use of the Hypomania Checklist (HCL-32). In cases where (hypo)mania is present in the anamnesis, mood stabilising treatment is warranted even in cases where depressive symptoms predominate the clinical course. However, the association between hypomania in the history and efficacy of mood stabilising lamotrigine treatment has not been previously investigated. In our present study we aimed to analyse clinical and psychosocial characteristics of HCL-32 identified lifetime "upbeat" periods, and to establish if there is an association between baseline-assessed HCL-32 3rd part total scores and remission and relapse rates during 6-month lamotrigine treatment. Our results indicate that baseline HCL-32 group 3rd part scores showed a trend for a moderately strong correlation with remission rates by the 4th visit, and a strong significant correlation was observable by the 5th visit. Overall relapse rate showed a significant strong correlation with baseline HCL-32 3rd part score. Therefore our results indicate that there is an association between baseline-assessed lifetime hypomania scores and higher remission and lower relapse rates during 6-month lamotrigine treatment indicating the efficacy of lamotrigine among patients with hypomania during their illness course.