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Adjunctive Treatment for Mood Stabilization of Patients with Bipolar I Disorder Treated with Lamotrigine

Published online by Cambridge University Press:  07 November 2014

Theodore Spaulding ,
Ronald Westlund ,
Christine Thomason ,
Robin White ,
Rebekkah Dann  and
Thomas Thompson
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Abstract

Objective:

To describe the effect of supplemental psychotropic medications, specifically anxiolytics with sedative/hypnotics (ASH) combined with lamotrigine (LTG) on stabilization of symptoms in patients with bipolar I disorder.

Method:

Symptomatic patients participating in two LTG maintenance trials were classified post-hoc as those initiating LTG as monotherapy (n=313) or as adjunctive therapy (n=814) and further characterized by supplemental add-on therapies received during an open-label treatment phase. Patients were considered stabilized if they reached a stable dose of LTG monotherapy (100–200 mg/day) and had a Clinical Global Impressions-Severity scale score ≤3 for at least 4 weeks. Stabilization rates were compared across initial- and supplemental-treatment groups.

Results:

Patients who initiated and were maintained on LTG monotherapy were stabilized at a slightly higher rate compared with those taking LTG adjunctive therapy (55% vs 48%; P=.080). Stabilization rates were numerically higher for LTG monotherapy patients who later received only ASH as supplemental medication compared with LTG monotherapy throughout, but this difference was not significant (66% vs 55%; P=.271). Stabilization rates were significantly higher for monotherapy patients who later received ASH alone versus other psychotropic medications (66% vs 28%; P=.001). For patients initiating LTG as adjunctive therapy, adding ASH alone resulted in significantly higher stabilization rates than adding another psychotropic medication (62% vs 33%; P<.001).

Conclusion:

LTG and adjunctive treatment with ASH may be useful in the treatment of acute mood symptoms in patients with bipolar I disorder.

Type
Original Research
Information
CNS Spectrums , Volume 11 , Issue 9 , September 2006 , pp. 711 - 718
Copyright
Copyright © Cambridge University Press 2006

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References

REFERENCES

1. Angst, J. The emerging epidemiology of hypomania and bipolar II disorder. J Affect Disord. 1998;50:143–151.Google Scholar
2. Marangell, LB. The importance of subsyndromal symptoms in bipolar disorder. J Clin Psychiatry. 2004;65(suppl 10):24–27.Google Scholar
3. Keitner, GI, Solomon, DA, Ryan, CE, et al. Prodromal and residual symptoms in bipolar I disorder. Compr Psychiatry. 1996;37:362–367.Google Scholar
4. The bipolar spectrum: rational polypharmacys. Bowden, CL, Wilcox, JA, eds. Arlington Heights, Ill, ACCESS Medical Group, Department of Continuing Education: 2005.Google Scholar
5. Practice guideline for the treatment of patients with bipolar disorder (revision). Am J Psychiatry. 2002;159(4 suppl):1–50.Google Scholar
6. Goodwin, GM. Evidence-based guidelines for treating bipolar disorder: recommendations from the British Association for Psychopharmacology. J Psychopharmacol. 2003;17:149–173.Google Scholar
7. Calabrese, JR, Kasper, S, Johnson, G, et al. International Consensus Group on Bipolar I Depression Treatment Guidelines. J Clin Psychiatry. 2004;65:571–579.Google Scholar
8. Suppes, T, Dennehy, EB, Hirschfeld, RM, et al. The Texas implementation of medication algorithms: update to the algorithms for treatment of bipolar I disorder. J Clin Psychiatry. 2005;66:870–886.Google Scholar
9. Yatham, LN, Kennedy, SH, O'Donovan, C, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies. Bipolar Disord. 2005;(7 suppl 3):5–69.Google Scholar
10. Bowden, CL, Calabrese, JR, Sachs, G, et al. A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently manic or hypomanic patients with bipolar I disorder. Arch Gen Psychiatry. 2003;60:392–400.Google Scholar
11. Calabrese, JR, Bowden, CL, Sachs, G, et al. A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently depressed patients with bipolar I disorder. J Clin Psychiatry. 2003;64:1013–1024.Google Scholar
12. Goodwin, GM, Bowden, CL, Calabrese, JR, et al. A pooled analysis of 2 placebo-controlled 18-month trials of lamotrigine and lithium maintenance in bipolar I disorder. J Clin Psychiatry. 2004;65:432–441.Google Scholar
13. Guy, W. ECDEU Assessment Manual for Psychopharmacology. rev. Washington, DC: Department of Health, Education and Welfare: 1976.Google Scholar