Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-26T03:40:07.376Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  18 September 2015

W.A. Nolen  and
R.W. Kupka
W.A. Nolen*
Affiliation:
Altrecht Institute for Mental Health Care and, University Medical Centre Utrecht, Utrecht, The Netherlands
R.W. Kupka
Affiliation:
Altrecht Institute for Mental Health Care and, University Medical Centre Utrecht, Utrecht, The Netherlands
*
Vrouwjuttenhof 18, 3512 PZ Utrecht, The Netherlands, Tel 31-30-2308850, Fax 31-30-2308834, E-mail w.nolen@altrecht.nl
Get access Rights & Permissions [Opens in a new window]

Abstract

Aims: 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.

Keywords

bipolar disorderlithiumvalproatelamotriginegabapentinprophylaxis
Type
Articles
Information
Acta Neuropsychiatrica , Volume 12 , Issue 3 , September 2000 , pp. 122 - 127
Copyright
Copyright © Cambridge University Press 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Kessler, RC, McGonagle, KA, Zhao, S, Nelson, CB, Hughes, M, Eshleman, S, Wittchen, HU, Kendler, KS. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry 1994;51:8–19.CrossRefGoogle ScholarPubMed
2.Bijl, RV, Van Zessen, G, Ravelli, A. Psychiatrische morbiditeit onder volwassenen in Nederland; II: prevalentie van Psychiatrische stoor-nissen. Ned Tijdschr Geneesk. 1997:141:2453–2460.Google Scholar
3.Davis, JM, Janicak, PG, Hogan, DM. Mood stabilizers in the prevention of recurrent affective disorders: a meta-analysis. Acta psychiatrica Scandinavica. 1999;100:406–417.CrossRefGoogle ScholarPubMed
4.Hartong, EGTM, Nolen, WA, Moleman, P, Hoogduin, CAL. Carbamazepine als profvlactische behandeling van de bipolaire stoornis. Tijdschr voor Psychiatr, 2000;42:327–336.Google Scholar
5.Medical Ethics Committee. Proposed revision of the World Medical Association Declaration of Helsinki. Ferney-Voltaire, France, World Medical Association. 1999. (WMA document: 17.C/Rev 1/98.)Google Scholar
6.Altshuler, LL, Post, RM, Leverich, GS, Mikalauskas, K, Rosoff, A, Ackerman, L. Antidepressantinduced mania and cycle acceleration: a controversy revisited. Am J Psychiatry 1995; 152:1130–1138.Google ScholarPubMed
7.Pope, HG, McElroy, SL, Keck, PE, Hudson, JI. Valproate in the treatment of acute mania; a placebo-controlled study. Arch Gen Psychiatry 1991;48:62–68.CrossRefGoogle Scholar
8.Freeman, TW, Clothier, JL, Pazzaglia, P, Lesern, MD, Swann, AC. A double-blind comparison of valproate and lithium in the treatment of acute mania. Am J Psychiatry 1992;149:108–111.Google ScholarPubMed
9.Bowden, CL, Brugger, AM, Swann, AC, Calabrese, JR, Janicak, PG, Petty, F, Dilsaver, SC, Davis, JM, Rush, AJ, Small, JG, et al. Efficacy of divalproex vs lithium and placebo in the treatment of mania. The Depakote Mania Study Group. JAMA 1994:271:918–924.CrossRefGoogle ScholarPubMed
10.Hirschfeld, RM, Allen, MH, McEvoy, JP, Keck, PE, Russell, JM. Safety and tolerability of oral loading divalproex sodium in acutely manic bipolar patients. J Clin Psychiatry 1999;60:815–818.CrossRefGoogle ScholarPubMed
11.Calabrese, JR, Bowden, CL, Sachs, GS, Ascher, JA, Monaghan, E, Rudd, GD. A double-blind placebo-controlled study of lamotrigine monotherapy in outpatients with bipolar I depression. J Clin Psychiatry 1999;60:79–88.CrossRefGoogle ScholarPubMed
12.Berk, M. Lamotrigine and the treatment of mania in bipolar disorder. Eur Neuropsychopharmacol 1999;9 Suppl 4:S119–123.CrossRefGoogle ScholarPubMed
13.Bowden, CL, Calabrese, JR, McElroy, SL, Gyulai, L. et al. A randomized, placebo-controlled 12-month trial of divalproex and lithium in treatment of outpatients with bipolar I disorder. Arch Gen Psychiatry 2000;57:481–489.CrossRefGoogle ScholarPubMed
14.Tohen, M, Sanger, TM, McElroy, SL, Tollefson, GD, Chengappa, KN, Daniel, DG, Petty, F, Centorrino, F, Wang, R, Grundy, SL, Greaney, MG, Jacobs, TG, David, SR, Toma, V. Olanzapine versus placebo in the treatment of acute mania. Am J Psychiatry 1999;156:702–709.CrossRefGoogle ScholarPubMed
15.Nolen, WA, Bloemkolk, D. Treatment of bipolar depression, a review of the literature and a suggestion for an algorithm. Neuropsychopharmacology 2000, in press.Google Scholar
16.Himmelhoch, JM, Thase, ME, Mallinger, AG, Houck, P. Tranylcypromine versus Imipramine in anergic bipolar depression. Am J Psychiatry 1991;48:910–919.Google Scholar