Efficacy and Safety of Lamotrigine as Add-On Treatment to Lithium in Bipolar Depression

Loos, Marc; Mulder, Paul; Hartong, Erwin G. Th. M.; Blom, Marc; Vergouwen, A. C. M.; Keyzer, Herman J. U. E. M. de; Notten, Peter; Luteijn, Marijke L.; Timmermans, Manuela A.; Vieta, Eduard; Nolen, Willem A.

doi:10.4088/jcp.08m04152

Cited by 211 publications

(146 citation statements)

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“…A more recent trial reported that the combination of risperidone plus paroxetine was not more efficacious than either agent alone [447], and this should be interpreted by having in mind the negative trial of paroxetine vs. quetiapine [339]. A more recent study reported that adding lamotrigine to lithium was better than placebo in patients with bipolar depression at week 8 [517]; however, it is questionable whether the effect persists beyond week 12 [515,516]. Another recent 8-week trial on 52 incomplete responders utilized adding carbamazepine or oxcarbazepine (600-1,200 mg daily) during maintenance treatment to lithium.…”

Section: Combination and Add-on Treatmentmentioning

confidence: 99%

Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry

Fountoulakis

Kasper

Andreassen

et al. 2012

Eur Arch Psychiatry Clin Neurosci

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118

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Section: Combination and Add-on Treatmentmentioning

confidence: 99%

Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry

Fountoulakis

Kasper

Andreassen

et al. 2012

Eur Arch Psychiatry Clin Neurosci

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118

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“…The discontinuation rate of 45.8% (11/24) in the present study is comparable to or higher than those in trials of other agents for bipolar depression, such as quetiapine, lithium and lamotrigine, that used the same treatment period of 8 weeks. The discontinuation rates in trials of quetiapine for bipolar depression were 45.6% (82 of 180 subjects) [ [18]. The above-mentioned trials were all randomized controlled trials with protocols and sample sizes different from those of open trials such as the present study.…”

Section: Discussionmentioning

confidence: 94%

Efficacy of Olanzapine for Treating Depressive Episodes in Bipolar Disorder

Kirino

2014

CNPT

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Purpose:We administered olanzapine to 24 outpatients with bipolar disorder who had experienced a depressive or mixed episode as their most recent episode to evaluate the efficacy and safety of olanzapine in clinical practice. Methods: The duration of study treatment was 8 weeks. Symptoms in each subject were assessed using the Montgomery Åsberg Depression Rating Scale (MADRS) and the Clinical Global Impressions-Severity of Illness, Bipolar Version (CGI-BP) at the start of treatment with olanzapine and at Week 4 and Week 8 of treatment. Results: A total of 17 subjects underwent the assessments at Week 4, and 13 subjects completed the 8-week treatment regimen and the assessments at Week 8. The mean total score and each individual item score of the MADRS were significantly improved at Week 4 and Week 8 compared to those at the start of treatment. The mean CGI-BP Depression and CGI-BP Overall scores were significantly improved at Week 4 and Week 8, while the mean CGI-BP Mania score was not significantly different at Week 4 or Week 8 compared to that at the start of treatment. Adverse drug reactions were reported in 3 subjects during the study: hyperphagia in 2 subjects and light-headed feeling in 1 subject. No manic switches were observed. Discussion: The results of this study confirmed the efficacy and safety of olanzapine in outpatients with bipolar depression in clinical practice.

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“…Examples include adding second-generation antipsychotics to lithium or valproate, adding valproate to antipsychotics, and combining treatment with lithium and valproate. Recent evidence regarding control of depression also supports the addition of lamotrigine to lithium and valproate to lamotrigine (Singh et al 2009;van der Loos et al 2009). …”

Section: Stevens-johnson Syndromementioning

confidence: 96%

Pharmacological Treatments for Bipolar Disorder: Present Recommendations and Future Prospects

Bowden¹

2010

Behavioral Neurobiology of Bipolar Disorder and Its Treatment

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In selecting and adapting medications to treat the specific clinical features of a patient with bipolar disorder (BPD) over time, a foundation strategy is to have good working knowledge of up-to-date practice guidelines. The World Federation of Societies of Biological Psychiatry Guidelines has the reasoned advantage of weighing safety/tolerability as high as efficacy. Most successful treatments for BPD start to separate from placebo within 1 week; most differences between regimens occur within the first 4 weeks. This observation extrapolates to a strategy of discontinuing or adding a second drug for symptoms unimproved within 1 month of treatment initiation. The weight of evidence argues against starting treatment with combination regimens, despite evidence that over time most patients do receive combination drug regimens and appear to tolerate them well. The current design paradigm for adjunctive trials generally strongly weights trials in favor of the sponsor drug.Well managed, BPD is often compatible with fully good health, both symptomatically and functionally. Consequently, for whatever regimens are found to accomplish excellent symptom control, it is important to achieve regimens that are well tolerated by all bodily systems. This chapter emphasizes the tactics needed to accomplish this specific to individual medications. The chapter also addresses the serious, broad failure of pharmaceutical companies to develop new drugs with novel mechanisms for BPD therapy and proposes a series of steps that might reenergize drug development to the benefit of psychiatrists and patients alike.

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Efficacy and Safety of Lamotrigine as Add-On Treatment to Lithium in Bipolar Depression

Cited by 211 publications

References 0 publications

Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry

Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry

Efficacy of Olanzapine for Treating Depressive Episodes in Bipolar Disorder

Pharmacological Treatments for Bipolar Disorder: Present Recommendations and Future Prospects

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