Carbamazepine in manic-depressive illness: a new treatment

The authors evaluated carbamazepine (Tegretol), a drug of choice for treatment of temporal lobe epilepsy, in a double-blind placebo-controlled trial in patients with manic-depressive illness. Seven of 9 manic patients had a partial to marked response; several also showed relapses when placebo was substituted and improvement when carbamazepine was reinstituted. Five of 13 depressed patients showed significant improvement in depression ratings; 3 additional patients experienced partial relapse when placebo was substituted. Carbamazepine might also have prophylactic as well as acute efficacy in patients with both phases of manic-depressive illness, including some patients who do not respond to lithium. Therapeutic effects were achieved with 600-1600 mg/day at blood levels of 8-12 microgram/ml with relatively few side effects. Carbamazepine may prove to be a useful additional treatment for affective illness.