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Acetazolamide in bipolar affective disorders

S G Hayes1

  • 1Department of Psychiatry and the Behavioral Sciences, University of Southern California, Rosemead 91770.

Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists
|June 1, 1994
PubMed
Summary

Acetazolamide shows promise for treating refractory bipolar disorder. In an open trial, 44% of patients with affective symptomatology responded positively, particularly those in depressive or rapid-cycling phases.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Pharmacology

Background:

  • Acetazolamide is a carbonic anhydrase inhibitor with known applications in epilepsy management.
  • Previous research suggested potential psychotropic effects, particularly in cyclically expressed atypical psychotic states.

Purpose of the Study:

  • To investigate the efficacy of acetazolamide in patients with treatment-refractory affective symptomatology.
  • To evaluate acetazolamide as a potential therapeutic option for complex mood disorders.

Main Methods:

  • A prospective open-label trial involving 16 patients with refractory affective symptoms.
  • Patients had undergone extensive prior treatment with various psychotropic medications, including antidepressants, lithium, carbamazepine, and divalproex.
  • Acetazolamide was administered as a treatment intervention.

Main Results:

  • Seven out of 16 patients (44%) demonstrated a positive response to acetazolamide.
  • Positive responses were sometimes dramatic and sustained for up to 2 years.
  • Responders were exclusively patients experiencing depressive or rapid-cycling phases of bipolar illness.
  • All responders had a history of partial positive response to at least one other anticonvulsant and were on concurrent anticonvulsant therapy.

Conclusions:

  • Acetazolamide may be an effective treatment for specific subgroups of patients with refractory bipolar disorder, particularly those with depressive or rapid-cycling features.
  • The findings support further investigation into acetazolamide's role in mood disorder management.
  • The study highlights the potential of carbonic anhydrase inhibitors in treating complex affective symptomatology.

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