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Long-term response to carbamazepine: a retrospective study.
F R Frankenburg1, M Tohen, B M Cohen
1Laboratories for Psychiatric Research, McLean Hospital, Belmont, Massachusetts 02178.
Journal of Clinical Psychopharmacology
|April 1, 1988
Summary
Carbamazepine shows limited long-term efficacy for bipolar disorder (BD) refractory to standard treatments. Troublesome side effects, especially hematological issues, were noted, suggesting infrequent long-term utility.
Area of Science:
- Psychiatry
- Pharmacology
- Neurology
Background:
- Carbamazepine is increasingly used for treatment-resistant bipolar disorder (BD).
- Limited data exists on its long-term utility and efficacy in BD management.
Purpose of the Study:
- To evaluate the long-term efficacy and tolerability of carbamazepine in patients with psychotic disorders, particularly BD.
- To assess the sustained benefits and side effects of carbamazepine in refractory cases.
Main Methods:
- Retrospective study of 50 patients with psychotic disorders, including 34 with BD.
- Analysis of acute response and long-term follow-up (3-4 years) for continued use and clinical benefit.
Main Results:
- Acute response observed in two-thirds of BD patients and two other diagnoses.
- Only seven BD patients (out of 34) continued carbamazepine long-term.
- Clear long-term benefit was confirmed in only two cases.
- Hematological abnormalities were significant troublesome side effects.
Conclusions:
- Carbamazepine demonstrates limited long-term efficacy for bipolar disorder refractory to standard treatments.
- Frequent side effects, particularly hematological issues, limit its sustained use.
- Carbamazepine is infrequently beneficial for long-term management of treatment-resistant psychotic disorders.