Posted by Ponder on April 19, 2002, at 10:18:16
In reply to Re: Update - Staying on Lamictal too, posted by Mondeo on April 17, 2002, at 9:00:25
19 April 2002
Third generation anticonvulsants 'fill unmet need' in bipolar disorder
The third generation anticonvulsant lamotrigine could fill an unmet need in the treatment of bipolar depression and rapid-cycling bipolar disorder, say researchers.Lakshmi Yatham (University of British Columbia, Vancouver, Canada) and colleagues comment that as many patients are unresponsive to lithium and most bipolar patients cannot be managed with monotherapy, the third generation anticonvulsants could prove effective options.
The team, therefore, carried out a review of studies and case reports on the efficacy of third generation anticonvulsants.
Overall, lamotrigine seemed the most useful anticonvulsant for bipolar depression and disorder, as a monotherapy or in combination with other mood stabilizers. It was also effective in prophylaxis of patients with bipolar I disorder. However, the drug did not appear to be specifically effective in treating acute mania.
Being less likely to induce a manic switch than antidepressants, the researchers recommend its use as a first-line agent for treating bipolar depression in patients with a history of severe and refractory manic episodes.
Gabapentine failed to show efficacy in treating patients with acute mania or in refractory bipolar disorder, and so is unlikely to be considered as a monotherapy for acute mania, bipolar depression, or bipolar disorder. Nevertheless, the researchers highlight its effectiveness in social phobia and possibly panic disorder.
Another potential adjunctive treatment for refractory mania and in ultrarapid or ultradian cycling disorder was topiramate, which in also potentially causing weight loss may make it an attractive add-on treatment.
The study is published in the Journal of Clinical Psychiatry.
J Clin Psychiatry 2002; 63: 275–283
poster:Ponder
thread:90100
URL: http://www.dr-bob.org/babble/20020416/msgs/103527.html