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Lamotrigine in rapid-cycling bipolar disorder
S H Fatemi1, D J Rapport, J R Calabrese
1Department of Psychiatry, University of Minnesota, Minneapolis, USA.
The Journal of Clinical Psychiatry
|February 4, 1998
Summary
Lamotrigine demonstrated antidepressant and mood-stabilizing effects in rapid-cycling bipolar patients, improving depressive symptoms and social function over time. This novel anticonvulsant showed sustained efficacy for an average of 7.5 months.
Area of Science:
- Psychiatry
- Pharmacology
- Neurology
Background:
- Investigated lamotrigine, an anticonvulsant, for antidepressant and mood-stabilizing properties in rapid-cycling bipolar disorder.
- Focused on patients with limited response to conventional mood stabilizers.
Observation:
- Open, prospective study with five rapid-cycling bipolar patients (DSM-IV).
- Lamotrigine administered as monotherapy or adjunct, titrated to at least 150 mg/day.
- Assessed using Global Assessment Scale (GAS), Beck Depression Inventory (BDI), and Young Mania Rating Scale (YMRS).
Findings:
- Significant dose- and time-dependent improvements in depressive symptoms (BDI) and social function (GAS).
- Lamotrigine treatment showed a significant reduction in mean BDI scores.
- No significant effect observed on mania symptoms (YMRS).
- Well-tolerated, with minimal side effects noted.
Implications:
- Lamotrigine shows potential as an effective monotherapy or augmentation strategy for rapid-cycling bipolar disorder.
- Sustained mood-stabilizing and antidepressant effects observed for up to 7.5 months.
- Further research warranted to explore lamotrigine's role in managing complex bipolar disorder cases.