The efficacy of valproate, lamotrigine and gabapentin in bipolar disorder; review of double-blind controlled studies

2000 ◽  
Vol 12 (3) ◽  
pp. 122-127 ◽  
Author(s):  
W.A. Nolen ◽  
R.W. Kupka
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Depression ◽  
Good Alternative ◽  
Effective Drug ◽  
Acute Mania ◽  
Sources Of Information ◽  
Double Blind ◽  
Proven Efficacy ◽  
Continuation Treatment

AbstractAims: The efficacy of the anticonvulsants valproate, lamotrigine and gabapentin in bipolar disorder is reviewed.Method: Using Medline ® and other sources of information, 12 double-blind controlled studies with either of these compounds were identified.Results: None of the compounds has been proven effective in the prophylaxis of bipolar disorder. Valproate has been found an effective drug in acute mania, while in continuation treatment after acute mania it proved to be save, i.e. not causing switches into depression. Lamotrigine is the only anticonvulsant with proven efficacy in acute bipolar depression. So far gabapentin has not been found effective.Conclusion: For the prophylaxis of bipolar disorder, lithium is still the treatment of choice. Carbamazepine and valproate are good alternatives, especially for patients not responding to lithium or not tolerating it. Lamotrigine may be a good alternative in bipolar depression.

scholarly journals Treatment of bipolar depression with supraphysiologic doses of levothyroxine: a randomized, placebo-controlled study of comorbid anxiety symptoms

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Maximilian Pilhatsch ◽  
Thomas J Stamm ◽  
Petra Stahl ◽  
Ute Lewitzka ◽  
Anne Berghöfer ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Rating Scale ◽  
Bipolar Depression ◽  
Phenotypic Expression ◽  
Anxiety Symptoms ◽  
Controlled Study ◽  
Double Blind ◽  
Comorbid Anxiety ◽  
Depressed Patients ◽  
Depressive Episodes

Abstract Background Symptoms of anxiety co-occur in a variety of disorders including in depressive episodes of bipolar disorder and in patients with thyrotoxicosis. Treatment of refractory bipolar disorder with supraphysiologic doses of levothyroxine (L-T4) has been shown to improve the phenotypic expression of the disorder and is associated with an increase of circulating thyroid hormones. However, it might be associated with somatic and mental adverse effects. Here we report the investigation of the influence of treatment with supraphysiologic doses of L-T4 on symptoms of anxiety in patients with refractory bipolar depression. Methods Post-hoc analysis from a 6-week, multi-center, randomized, double-blind, placebo-controlled study of the effects of supraphysiologic L-T4 treatment on anxiety symptoms in bipolar depression. Anxiety symptoms were measured weekly with the Hamilton anxiety/somatization factor (HASF) score of the Hamilton Depression Rating Scale (HAMD) and the State- and Trait Anxiety Inventory (STAI). Results Treatment of both groups was associated with a significant reduction in anxiety symptoms (p < 0.001) with no statistical difference between groups (LT-4: from 5.9 (SD = 2.0) at baseline to 3.7 (SD = 2.4) at study end; placebo: from 6.1 (SD = 2.4) at baseline to 4.4 (SD = 2.8) at study end; p = 0.717). Severity of anxiety at baseline did not show a statistically significant correlation to the antidepressive effect of treatment with supraphysiologic doses of L-T4 (p = 0.811). Gender did not show an influence on the reduction of anxiety symptoms (females: from 5.6 (SD = 1.7) at baseline to 3.5 (SD = 2.4) at study end; males: from 6.1 (SD = 2.3) at baseline to 4.0 (SD = 2.4) at study end; p = 0.877). Conclusions This study failed to detect a difference in change of anxiety between bipolar depressed patients treated with supraphysiologic doses of L-T4 or placebo. Comorbid anxiety symptoms should not be considered a limitation for the administration of supraphysiologic doses of L-T4 refractory bipolar depressed patients. Trial registration ClinicalTrials, ClinicalTrials.gov identifier: NCT01528839. Registered 2 June 2012—Retrospectively registered, https://clinicaltrials.gov/ct2/show/study/NCT01528839

Double-Blind, Randomized, Placebo-Controlled Trials of Ethyl-Eicosapentanoate in the Treatment of Bipolar Depression and Rapid Cycling Bipolar Disorder

2006 ◽  
Vol 60 (9) ◽  
pp. 1020-1022 ◽  
Author(s):  
Paul E. Keck ◽  
Jim Mintz ◽  
Susan L. McElroy ◽  
Marlene P. Freeman ◽  
Trisha Suppes ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Depression ◽  
Controlled Trials ◽  
Rapid Cycling ◽  
Double Blind

The treatment of bipolar disorder in children and adolescents

2017 ◽  
Author(s):  
Philip Hazell
Keyword(s):  
Clinical Trial ◽  
Bipolar Disorder ◽  
Young People ◽  
Relapse Prevention ◽  
Bipolar Depression ◽  
Mood Stabilizer ◽  
Acute Mania ◽  
Clinical Trial Evidence ◽  
Second Generation Antipsychotic ◽  
Trial Evidence

The presentation of bipolar disorder in young people can be different from that of adults; therefore, the approach to treatment differs slightly. Treatment is described for early intervention, acute mania, bipolar depression, relapse prevention, and refractory bipolar disorder. A strong therapeutic alliance with the patient and engagement and involvement of the patient’s family is critical to successful intervention. The evidence informing treatment is limited, but there is emerging research focused on the management of acute mania favouring monotherapy with a second-generation antipsychotic (SGA) over a mood stabilizer. Preliminary data favour a combination of an SGA and antidepressant over monotherapy with an SGA for the treatment of bipolar depression. Guidelines endorse electroconvulsive therapy for refractory mania and bipolar depression but there is no clinical trial evidence to support this practice. The development of algorithms to guide the management of all phases of bipolar disorder is a work in progress.

Anticonvulsants in Bipolar Disorder

2006 ◽  
Vol 40 (5) ◽  
pp. 386-393 ◽  
Author(s):  
Charles L. Bowden ◽  
Nancy U. Karren
Keyword(s):  
Bipolar Disorder ◽  
Maintenance Therapy ◽  
Bipolar Depression ◽  
Anticonvulsant Drugs ◽  
Effective Drug ◽  
Review Of The Literature ◽  
Selective Review ◽  
Secondary Analyses

Objective: To review the literature on the effectiveness of anticonvulsant drugs in the management of bipolar disorder. Methods: A selective review of the literature. Results: Valproate is an effective drug, alone or in combination, for mania, but has limited benefit in bipolar depression. Although valproate is widely used in maintenance therapy of bipolar disorder, and secondary analyses suggest benefit, in the largest randomised maintenance trial there was only a trend favouring valproate. Lamotrigine has benefit in bipolar depression and maintenance, but not in mania. Carbamazepine is effective in mania. Other anticonvulsant drugs have been tried in mania, but with mixed results. Conclusions: Valproate, lamotrigine and carbamazepine have a valuable place in the management of bipolar disorder.

Risperidone for the treatment of acute mania in children and adolescents with bipolar disorder: a randomized, double-blind, placebo-controlled study

2009 ◽  
Vol 11 (7) ◽  
pp. 687-700 ◽  
Author(s):  
Magali Haas ◽  
Melissa P DelBello ◽  
Gahan Pandina ◽  
Stuart Kushner ◽  
Ilse Van Hove ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Children And Adolescents ◽  
Acute Mania ◽  
Controlled Study ◽  
Double Blind ◽  
Double Blind Placebo

scholarly journals The validity and internal structure of the Bipolar Depression Rating Scale: data from a clinical trial of N-acetylcysteine as adjunctive therapy in bipolar disorder

2010 ◽  
Vol 22 (5) ◽  
pp. 237-242 ◽  
Author(s):  
Michael Berk ◽  
Seetal Dodd ◽  
Olivia M Dean ◽  
Kristy Kohlmann ◽  
Lesley Berk ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Bipolar Disorder ◽  
Internal Structure ◽  
Adjunctive Therapy ◽  
Rating Scale ◽  
Bipolar Depression ◽  
Controlled Clinical Trial ◽  
Double Blind ◽  
Rating Scale Data ◽  
Scale Data

Berk M, Dodd S, Dean OM, Kohlmann K, Berk L, Malhi GS. The validity and internal structure of the Bipolar Depression Rating Scale: data from a clinical trial of N-acetylcysteine as adjunctive therapy in bipolar disorder.Background:The phenomenology of unipolar and bipolar disorders differ in a number of ways, such as the presence of mixed states and atypical features. Conventional depression rating instruments are designed to capture the characteristics of unipolar depression and have limitations in capturing the breadth of bipolar disorder.MethodThe Bipolar Depression Rating Scale (BDRS) was administered together with the Montgomery Asberg Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) in a double-blind randomised placebo-controlled clinical trial of N-acetyl cysteine for bipolar disorder (N = 75).Results:A factor analysis showed a two-factor solution: depression and mixed symptom clusters. The BDRS has strong internal consistency (Cronbach's alpha = 0.917), the depression cluster showed robust correlation with the MADRS (r = 0.865) and the mixed subscale correlated with the YMRS (r = 0.750).Conclusion:The BDRS has good internal validity and inter-rater reliability and is sensitive to change in the context of a clinical trial.

72. Light Therapy for Bipolar Disorder: A Randomized, Double-Blind, Placebo-Controlled Trial of Bright White versus Dim Red Light for Bipolar Depression

2017 ◽  
Vol 81 (10) ◽  
pp. S30
Author(s):  
Dorothy Sit ◽  
James McGowan ◽  
Christopher Wiltrout ◽  
Rasim Somer Diler ◽  
John (Jesse) Dills ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Depression ◽  
Controlled Trial ◽  
Red Light ◽  
Light Therapy ◽  
Double Blind ◽  
Double Blind Placebo
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