Long-term outcome of bipolar depressed patients receiving lamotrigine as add-on to lithium with the possibility of the addition of paroxetine in nonresponders: a randomized, placebo-controlled trial with a novel design

Loos, Marc; Mulder, Paul; Hartong, Erwin G. Th. M.; Blom, Marc; Vergouwen, A. C. M.; Noorden, Martijn S. van; Timmermans, Manuela A.; Vieta, Eduard; Nolen, Willem A.

doi:10.1111/j.1399-5618.2011.00887.x

Cited by 50 publications

(56 citation statements)

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“…Another study reported that valproate was more efficacious than lithium when added to antidepressants for the prevention of bipolar depression [242], and a recent double-blind study suggested that adding an antidepressant (bupropion, sertraline or venlafaxine) on a mood stabilizer improved both the acute-phase outcome and after 1-year follow-up without inducing mania [17]. One study reports that adding lamotrigine to lithium was better than placebo in patients with bipolar depression [517] and its extension with the addition of paroxetine gave some additional positive results [516]. There is also one positive add-on study on long-acting injectable risperidone [320].…”

Section: Combination and Add-on Treatmentmentioning

confidence: 97%

“…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: 97%

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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: 97%

Section: Combination and Add-on Treatmentmentioning

confidence: 97%

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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“…During a one-year extension phase of an RCT, median time to relapse or recurrence was longer among responders receiving lamotrigine compared to those receiving placebo as an addon to lithium ± paroxetine (ten versus 3.5months) (164).…”

Section: Pharmacological Treatments For Maintenance Therapymentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013

et al. 2012

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Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Beaulieu S, Alda M, O’Donovan C, MacQueen G, McIntyre RS, Sharma V, Ravindran A, Young LT, Milev R, Bond DJ, Frey BN, Goldstein BI, Lafer B, Birmaher B, Ha K, Nolen WA, Berk M.  Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013.  Bipolar Disord 2012: 00: 000–000. © 2012 John Wiley & Sons A/S.Published by Blackwell Publishing Ltd.The Canadian Network for Mood and Anxiety Treatments published guidelines for the management of bipolar disorder in 2005, with updates in 2007 and 2009. This third update, in conjunction with the International Society for Bipolar Disorders, reviews new evidence and is designed to be used in conjunction with the previous publications.The recommendations for the management of acute mania remain largely unchanged. Lithium, valproate, and several atypical antipsychotic agents continue to be first‐line treatments for acute mania. Monotherapy with asenapine, paliperidone extended release (ER), and divalproex ER, as well as adjunctive asenapine, have been added as first‐line options.For the management of bipolar depression, lithium, lamotrigine, and quetiapine monotherapy, as well as olanzapine plus selective serotonin reuptake inhibitor (SSRI), and lithium or divalproex plus SSRI/bupropion remain first‐line options. Lurasidone monotherapy and the combination of lurasidone or lamotrigine plus lithium or divalproex have been added as a second‐line options. Ziprasidone alone or as adjunctive therapy, and adjunctive levetiracetam have been added as not‐recommended options for the treatment of bipolar depression. Lithium, lamotrigine, valproate, olanzapine, quetiapine, aripiprazole, risperidone long‐acting injection, and adjunctive ziprasidone continue to be first‐line options for maintenance treatment of bipolar disorder. Asenapine alone or as adjunctive therapy have been added as third‐line options.

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“…Pharmacological therapy is often the first-line treatment for BD, followed by psychological (Oud et al, 2016) and psychosocial interventions (Goodwin et al, 2008). In addition to lithium and anticonvulsants (van der Loos et al, 2011;Yildiz et al, 2015), antipsychotic agents have also shown promising efficacy for bipolar mania (Yildiz et al, 2011) and depression (Goodwin et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Efficacy, safety and tolerability of aripiprazole in bipolar disorder: An updated systematic review and meta-analysis of randomized controlled trials

Tseng²,

Stubbs

et al. 2017

Progress in Neuro-Psychopharmacology and Biological Psychiatry

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-keung Chow , Efficacy, safety and tolerability of aripiprazole in bipolar disorder: An updated systematic review and meta-analysis of randomized controlled trials. The address for the corresponding author was captured as affiliation for all authors. Please check if appropriate. Pnp(2017Pnp( ), doi: 10.1016Pnp( /j.pnpbp.2017 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.A C C E P T E D M A N U S C R I P T Aripiprazole was associated with lower relapse rates in bipolar mania when used in combination versus a placebo in maintenance therapy (odds ratio: 0.522, p<0.029). ACCEPTED MANUSCRIPT A C C E P T E D M A N U S C R I P TAripiprazole was also associated with higher levels of high density lipoprotein, lower dropout rates, but no difference in extrapyramidal symptoms in the maintenance phase versus a placebo or in comparison with other medications (haloperidol or lithium). Our results suggest that aripiprazole is effective and safe in treating bipolar mania. Further trials are necessary to evaluate the efficacy and tolerability versus other medications.

show abstract

Long-term outcome of bipolar depressed patients receiving lamotrigine as add-on to lithium with the possibility of the addition of paroxetine in nonresponders: a randomized, placebo-controlled trial with a novel design

Abstract: In patients with bipolar depression, despite continued use of lithium, addition of lamotrigine revealed a continued benefit compared to placebo throughout the entire study.

Cited by 50 publications

References 32 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

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013

Efficacy, safety and tolerability of aripiprazole in bipolar disorder: An updated systematic review and meta-analysis of randomized controlled trials

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