Topiramate versus Bupropion SR when added to mood stabilizer therapy for the depressive phase of bipolar disorder: a preliminary single‐blind study

McIntyre, Roger S.; Mancini, Deborah; McCann, Sonia; Srinivasan, Janaki; Sagman, Doron; Kennedy, Sidney H.

doi:10.1034/j.1399-5618.2002.01189.x

Cited by 154 publications

(82 citation statements)

References 31 publications

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“…[63][64][65][66] Rigorously performed, controlled trials, however, failed to find any benefit from use of this drug in bipolar disorder. 67 Topiramate has been commonly prescribed for patients with bipolar disorder, not only because of the expectation that it will prove to be efficacious, but also because of its weight-reducing effects, which are felt to be particularly desirable to counteract the weight gain induced by some other mood stabilizing agents (e.g., valproic acid).…”

Section: Topiramatementioning

confidence: 99%

Use of Antiepileptic Drugs for Nonepileptic Conditions: Psychiatric Disorders and Chronic Pain

2007

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Summary: Antiepileptic drugs (AEDs) are commonly utilized for nonepileptic conditions, including various psychiatric disorders and pain syndromes. Evidence for their benefit in these nonepileptic conditions varies widely among different drugs, but there is, in general, a paucity of published multicenter randomized double-blind trials. Variable levels of evidence suggest that lamotrigine and the vagal nerve stimulator have antidepressant properties. Carbamazepine, valproate, lamotrigine, and oxcarbazepine appear to have mood stabilizing properties while gabapentin, pregabalin, and tiagabine have anxiolytic benefits. Barbiturates, topiramate, and possibly phenytoin may precipitate or exacerbate depression. Underlying depression and anxiety symptoms may be exacerbated by levetiracetam, while psychotic symptoms have rarely been reported with topiramate, levetiracetam, and zonisamide. Pregabalin, gabapentin, carbamazepine, and oxcarbazepine have been used to treat neuropathic pain such as postherpetic neuralgia, and diabetic polyneuropathy. Topiramate and divalproex sodium have utility in the prophylaxis or acute treatment of migraine. Further rigorous studies are needed to clarify the utility of AEDs in nonepileptic conditions.

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Section: Topiramatementioning

confidence: 99%

Use of Antiepileptic Drugs for Nonepileptic Conditions: Psychiatric Disorders and Chronic Pain

2007

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“…Topiramate has demonstrated substantial beneficial effects in the treatment of bipolar disorder in open-label trials (Marcotte, 1998;Chengappa et al, 1999;McElroy et al, 2000;Chengappa et al, 2001a;Guille and Sachs, 2002;McIntyre et al, 2002;Vieta et al, 2002). Phase III trials of topiramate as monotherapy for acute bipolar mania, did not demonstrate a statistically significant advantage over placebo, although all studies demonstrated significant weight loss (Data on file, 2003).…”

Section: Newer Treatments For Bipolar Disordermentioning

confidence: 99%

Comorbidity in bipolar disorder: a framework for rational treatment selection

McIntyre

Konarski

Yatham

2004

Human Psychopharmacology

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Bipolar disorders are heterogeneous disorders often requiring multimodality treatment. The expanding pharmacopeia for bipolar disorders invites the need for a treatment framework that both recognizes and anticipates the multidimensionality and comorbidity of the illness. No available neurotherapeutic agent is singularly efficacious for the complete mélange of bipolar symptomatology. An apparent paradox has emerged in the management of bipolar disorder; whilst results from rigorous controlled monotherapy trials suggest that a disparate assortment of neurotherapeutic agents are efficacious in distinct phases of bipolar disorder, the majority of tertiary-treated bipolar patients receive polypharmacotherapeutic regimens. The evidentiary base for polypharmacotherapy is sparse and has recently become an area of active research focus. In the interim, clinicians are encouraged to invoke an organizational schema for the treatment of bipolar disorder that considers the spectrum of effectiveness of putative and established mood stabilizers. This schema should be further informed by the treatment data for comorbid and accessory conditions. The authors propose a schema to provide the impetus for further work in the area.

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“…Estudos abertos sobre os efeitos do topiramato no tratamento de episódios de mania, mistos e de depressão do TB sugeriram um possível benefício em casos de má resposta aos tratamentos (Hussain et al, 2001;McIntyre et al, 2002). O estudo de McIntyre et al (2002), inclusive, que comparou o topiramato e a bupropiona, com desenho simples-cego (n = 36), não evidenciou diferenças significativas em relação à eficácia nos dois grupos.…”

Section: Topiramatounclassified

“…O estudo de McIntyre et al (2002), inclusive, que comparou o topiramato e a bupropiona, com desenho simples-cego (n = 36), não evidenciou diferenças significativas em relação à eficácia nos dois grupos. São necessários, contudo, estudos duploscegos controlados para a melhor avaliação dos benefí-cios do topiramato no tratamento da depressão bipolar.…”

Section: Topiramatounclassified

Tratamento da depressão bipolar

Lafer

Soares²

2005

Rev. psiquiatr. clín.

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ResumoO tratamento da depressão bipolar tem sido tema de debate. O uso de antidepressivos, principalmente tricíclicos, nestes pacientes está associado a piores desfechos clínicos. Estudos apontam para uma eficácia limitada de estabilizadores tradicionais como lítio, valproato e carbamazepina no tratamento da depressão bipolar. Em casos de depressão mais grave, há indicativos de que os antidepressivos podem ser úteis, sendo recomendado o uso concomitante de um estabilizador do humor. Novos agentes como a lamotrigina têm sido propostos como efetivos no tratamento da depressão bipolar. Estudos recentes utilizando lamotrigina sugerem a sua eficácia e seguraça no tratamento da depressão bipolar.Palavras-chave: Depressão bipolar, tratamento, antidepressivos. AbstractThe treatment of bipolar depression has been an area of debate. The use of antidepressants, particularly the triciclics, has been associated with worse clinical outcomes. Evidence points to a limited efficacy of traditional mood stabilizers such as lithium, valproate and carbamazepine in the treatment of bipolar depression. In cases where depression is more severe, there is evidence that antidepressants may be useful. The use of antidepressants should be in association with a mood stabilizer. New agents such as lamotrigine have been put forward as effective in the treatment of bipolar depression. Recent studies using lamotrigine suggest its efficacy and safety in the treatment of bipolar depression.

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Topiramate versus Bupropion SR when added to mood stabilizer therapy for the depressive phase of bipolar disorder: a preliminary single‐blind study

Abstract: These preliminary data suggest that adjunctive topiramate may reduce depressive symptom severity in acute bipolar depression. The antidepressant efficacy of this compound requires confirmation via double-blind placebo controlled investigation.

Cited by 154 publications

References 31 publications

Use of Antiepileptic Drugs for Nonepileptic Conditions: Psychiatric Disorders and Chronic Pain

Use of Antiepileptic Drugs for Nonepileptic Conditions: Psychiatric Disorders and Chronic Pain

Comorbidity in bipolar disorder: a framework for rational treatment selection

Tratamento da depressão bipolar

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