A single blind comparison of lithium and lamotrigine for the treatment of bipolar II depression

Suppes, Trisha; Marangell, Lauren B.; Bernstein, Ira H.; Kelly, Dorothy I.; Fischer, E. Grace; Zboyan, Holly A.; Snow, Diane; Martínez, Melissa; Jurdi, Rayan Al; Shivakumar, Geetha; Sureddi, Suresh; Gonzalez, Robert

doi:10.1016/j.jad.2008.02.004

Cited by 87 publications

(69 citation statements)

References 30 publications

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“…The mean (range) age was 35.5 (15-58) years. The average (range) number of previous mood episodes was 4.1 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10), and that of duration of the present depressive episode was 14.4 (1-40) months. The age of onset and duration of the disease were 28.1±12.5 years and 7.9±7.1 years, respectively.…”

Section: Subjectsmentioning

confidence: 99%

“…Also, LTG augmentation is suggested to have greater advantages in treating more severely depressed patients with bipolar disorders [5] and have benefit for pediatric bipolar disorders [7]. The efficacy of LTG is regarded to be comparable to that of lithium for the treatment of bipolarⅡdisorder [8]. On the other hand, the efficacy of LTG as monotherapy in the acute treatment of bipolar disorder is still controversial [8,9].…”

Section: Introductionmentioning

confidence: 99%

“…The efficacy of LTG is regarded to be comparable to that of lithium for the treatment of bipolarⅡdisorder [8]. On the other hand, the efficacy of LTG as monotherapy in the acute treatment of bipolar disorder is still controversial [8,9]. A few studies have examined whether LTG augmentation therapy is also applicable to unipolar TRMD.…”

Section: Introductionmentioning

confidence: 99%

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Lamotrigine augmentation for the treatment-resistant mood disorder

Kagawa

Nemoto

Suzuki

et al. 2010

CNPT

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Purpose: A number of depressed patients do not respond adequately to standard antidepressant treatments, and some of them subsequently suffer from treatment-resistant mood disorder (TRMD). Lamotrigine (LTG) is the only mood stabilizer that is effective for preventing depressive episodes of bipolar disorders. This study aimed to evaluate the efficacy of LTG augmentation in Japanese patients with TRMD. Methods: The subjects were 30 patients with refractory depression who had already shown insufficient response to multiple pharmacotherapy including antidepressants, mood stabilizers and atypical antipsychotics. The diagnoses were major depressive disorder (n=16), bipolar disorder (n=10) and dysthymic disorder (n=4). All patients gave written informed consent to receive LTG as an off-label indication in Japan after explanation for possible risks of unwanted skin reactions. The daily dose of LTG was titrated by the clinician's decision (88.0±61.9 mg/day). Treatment response was assessed by Montgomery-Åsberg Depression Rating Scale (MADRS) and Global Assessments of Functioning (GAF) before and after the 8-week LTG augmentation. Results: Significant improvements were observed in the scores of MADRS (25.3±10.1 → 14.7±10.5) and GAF (49.2±12.3 → 64.1±11.7) after the 8-week LTG augmentation (p=0.0010). Greater number of the past mood episodes and shorter duration of the present depressive episode are associated with better response to LTG. Mild adverse skin reactions developed in 10 patients although 8 out of them were treatment responders. Discussion: LTG augmentation may be effective for the treatment of TRMD, especially with shorter duration of unremitted depression and more recurrent episodes. However, attention should be paid to the development of adverse skin reactions in LTG responders.

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Section: Subjectsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lamotrigine augmentation for the treatment-resistant mood disorder

Kagawa

Nemoto

Suzuki

et al. 2010

CNPT

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“…The plasma levels of lithium after 1 week of 0.2% Li 2 CO 3 treatments are within the recommended therapeutic range (0.5-1.2 mEq/l) (Suppes et al, 2008: Bauer et al, 2010.…”

Section: Drugmentioning

confidence: 56%

Subchronic lithium treatment increases the anxiolytic-like effect of mirtazapine on the expression of contextual conditioned fear

Inoue

Kitaichi

et al. 2015

European Journal of Pharmacology

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Lithium not only has a mood-stabilizing effect but also the augmentation effect of an antidepressant, the mechanism of which remains unclear. Although lithium may augment the effect of mirtazapine, this augmentation has not been confirmed. Using a contextual fear conditioning test in rats, an animal model of anxiety or fear, we examined the effect of subchronic lithium carbonate (in diet) in combination with systemic mirtazapine on the expression of contextual conditioned fear. Mirtazapine (10 mg/kg) reduced freezing one day after fear conditioning dose-dependently, whereas the anxiolytic-like effect of mirtazapine (10 mg/kg) diminished seven days after fear conditioning. When the interval between fear conditioning and testing was seven days, only the combination of subchronic 0.2% Li 2 CO 3 but not 0.05% Li 2 CO 3 with acute mirtazapine (10 mg/kg) reduced freezing significantly. These results indicate that subchronic 0.2% Li 2 CO 3 treatment enhanced the anxiolytic-like effect of systemic mirtazapine. This augmentation therapy might be useful for the treatment of anxiety disorders.

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“…Comprehensive analyses of these data revealed the rapid and consistent efficacy of QTP monotherapy for depressive episodes of bipolar II disorder [48]. Meanwhile, several smaller studies that Li, LTG and VPA exhibit efficacy in acute phase treatment for bipolar II depression [49,50]. Since maintenance therapy for bipolar II disorder should focus mainly on preventing depressive recurrence, which is common, LTG, a predominantly antidepressive mood stabilizer, is highly recommended by the NICE guidelines as an option for poor responders in addition to the first-line mood stabilizers [16].…”

Section: Bipolar II Disordermentioning

confidence: 99%

How can we classify “mood stabilizers” with different properties?

Kondo

2011

CNPT

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Mood stabilizers have been conventionally defined as drugs possessing efficacy in both acute and maintenance therapy for any polarity of bipolar disorder. Only lithium has been regarded as the gold standard mood stabilizer, fulfilling all of these conditions. Recently, evidence for the comprehensive mood-stabilizing effects of second-generation antipsychotics such as quetiapine and olanzapine has been found, although their safety in long-term use is still of great concern. Antiepileptic drugs do not appear to be ideal mood stabilizers because of selective effectiveness on a particular polarity --for example, valproate and carbamazepine are predominantly antimanic, and lamotrigine is predominantly antidepressive. However, the mood-stabilizing effects of combinations of these drugs may be equivalent or even superior to that of lithium alone, especially in pathophysiologies less responsive to lithium, such as dysphoric mania, mixed features and rapid cycling.

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A single blind comparison of lithium and lamotrigine for the treatment of bipolar II depression

Abstract: Background-Treatment studies are lacking for patients with bipolar II disorder (BDII). The objective of this study was to compare lamotrigine (LTG) and lithium (Li) monotherapy for the treatment of BDII depression.

Cited by 87 publications

References 30 publications

Lamotrigine augmentation for the treatment-resistant mood disorder

Lamotrigine augmentation for the treatment-resistant mood disorder

Subchronic lithium treatment increases the anxiolytic-like effect of mirtazapine on the expression of contextual conditioned fear

How can we classify “mood stabilizers” with different properties?

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A single blind comparison of lithium and lamotrigine for the treatment of bipolar II depression

Abstract: Background-Treatment studies are lacking for patients with bipolar II disorder (BDII). The objective of this study was to compare lamotrigine (LTG) and lithium (Li) monotherapy for the treatment of BDII depression.

Cited by 87 publications

References 30 publications

Lamotrigine augmentation for the treatment-resistant mood disorder

Lamotrigine augmentation for the treatment-resistant mood disorder

Subchronic lithium treatment increases the anxiolytic-like effect of mirtazapine on the expression of contextual conditioned fear

How can we classify &ldquo;mood stabilizers&rdquo; with different properties?

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How can we classify “mood stabilizers” with different properties?