The use of sodium valproate, carbamazepine and oxcarbazepine in patients with affective disorders

Oxcarbazepine in the Treatment of Bipolar Disorder: A Review

“…Owing to the fact that it appears to have similar efficacy to haloperidol (4,35), lithium (35), and VPA, OXC can be used as a monotherapy or as an add-on therapy in patients with acute mania who have not responded to or cannot tolerate lithium, VPA, or antipsychotics (32). The addition of OXC to other psychotropic medications, including lithium, antidepressants, and other mood stabilizers, is also an effective strategy in refractory bipolar (19)(20)(21)(22)(23)25,27,30) and schizoaffective disorders (21,27,(32)(33)(34)45).…”

“…Emrich and others conducted the first double-blind, placebocontrolled ABA design study (A representing placebo and B representing medication) (33,34). Of the VPA group, 5 patients were studied, and of the OXC group, 6 patients were studied, one of whom underwent 2 trials.…”

Beyond Lithium in the Treatment of Bipolar Illness

“…This is convergent with the data of Bowden et al (1996), indicating that patients with blood levels over 45 g/ml were better early responders to valproate. Open studies by a variety of investigators indicate that valproate has prophylactic effects against recurrences of both acute mania and acute depression in a variety of patients subgroups, including those with dysphoric mania, rapid cycling, and a variety of other traditionally inadequately treated subgroups of bipolar patients (Lambert 1984;Emrich et al 1984;Fawcett 1988;Delucchi 1989, 1990;Post 1989;Schaff et al 1993;Lambert and Venaud 1995).…”

Psychiatric Uses of Newer Anticonvulsants

“…43 In a double-blind, crossover study, 6 of 7 patients treated with oxcarbazepine showed improvement and had an almost 86% decrease in Inpatient Multidimensional Psychiatric Scale score. 44 Oxcarbazepine was also studied as an add-on medication in 10 patients with either manic symptoms or schizoaffective disorder; the overall results were favorable, especially in treatment of manic symptoms and hostility. 45 Another open clinical trial studied 13 patients with bipolar disorder, mostly nonresponders to lithium, who were given either carbamazepine or oxcarbazepine.…”