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Open-Label, Concomitant Use of Lamotrigine and Other Medications for Bipolar Disorder

Published online by Cambridge University Press:  07 November 2014

Charles L. Bowden ,
Suzanne Edwards  and
Gary Evoniuk
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Abstract

Objective:

A post-hoc, descriptive analysis was undertaken to assess the tolerability of and changes in psychiatric rating scales with lamotrigine (LTG) administered concomitantly with commonly prescribed bipolar medications.

Methods:

During the 8- to 16-week, open-label, preliminary phase of two large clinical trials of patients (N=1,305) with bipolar I disorder, LTG was added to each patient's existing psychotropic regimen. Medications for acute symptoms could have been added and later discontinued to achieve LTG monotherapy. Data were compared for patients taking LTG with or without concomitant valproate, lithium, any atypical antipsychotic, or any selective serotonin reuptake inhibitor.

Results:

The percentages of patients with any reported adverse event and reported adverse events of mood symptoms or rash were comparable between those taking LTG with or without other concomitant bipolar medications. Adverse events in >10% of patients in at least one subgroup were headache, infection, nausea, rash, influenza, diarrhea, dizziness, and somnolence. Baseline scores on psychiatric rating scales improved similarly with LTG co-administered with other bipolar medications, and the pattern of results did not differ by baseline polarity of mood symptoms.

Conclusion:

LTG co-administered with valproate, lithium, an atypical antipsychotic, or a selective serotonin reuptake inhibitor in the treatment of bipolar disorder seemed to be well tolerated and was associated with clinical improvement.

Type
Original Research
Information
CNS Spectrums , Volume 13 , Issue 1 , January 2008 , pp. 75 - 83
Copyright
Copyright © Cambridge University Press 2008

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References

REFERENCES

1.Weissman, MM, Bland, RC, Canino, GJ, et al.Cross-national epidemiology of major depression and bipolar disorder. JAMA. 1996;276:293–299.CrossRefGoogle ScholarPubMed
2.Kessler, RC, McGonagle, KA, Zhao, S, et al.Lifetime and 12-month prevalence of DMS-III-R psychiatric disorders in the United States: Results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994;51:8–19.CrossRefGoogle Scholar
3.Keck, PE, McElroy, SL, Arnold, LM. Bipolar disorder. Med Clin North Am. 2001;85:645–661.CrossRefGoogle ScholarPubMed
4.Nemeroff, CB. An ever-increasing pharmacopoeia for the management of patients with bipolar disorder. J Clin Psychiatry. 2000;61(suppl 13):19–25.Google ScholarPubMed
5.Freeman, MP, Stoll, AL. Mood stabilizer combinations: a review of safety and efficacy. Am J Psychiatry. 1998;155:12–21.CrossRefGoogle ScholarPubMed
6.Bowden, CL. Lamotrigine in the treatment of bipolar disorder. Expert Opin Pharmacother. 2002;3:1513–1519.CrossRefGoogle ScholarPubMed
7.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.CrossRefGoogle ScholarPubMed
8.Calabrese, J, Bowden, C, 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.CrossRefGoogle ScholarPubMed
9.Calabrese, JR, Vieta, E, Shelton, MD. Latest maintenance data on lamotrigine in bipolar disorder. Eur Neuropsychopharmacol. 2003;13(suppl 2):S57–S66.CrossRefGoogle ScholarPubMed
10.Pies, R. Combining lithium and anticonvulsants in bipolar disorder: a review. Ann Clin Psychiatry. 2002;14:223–232.CrossRefGoogle ScholarPubMed
11.Zarate, CA Jr, Quiroz, JA. Combination treatment in bipolar disorder: a review of controlled trials. Bipolar Disord. 2003;5:217–225.CrossRefGoogle ScholarPubMed
12.Goodwin, FK. Rationale for using lithium in combination with other mood stabilizers in the management of bipolar disorder. J Clin Psychiatry. 2003;64(suppl 5):18–24.Google ScholarPubMed
13.Ketter, TA, Calabrese, JR. Stabilization of mood from below versus above baseline in bipolar disorder: A new nomenclature. J Clin Psychiatry. 2002;63:146–151.CrossRefGoogle ScholarPubMed
14.Messenheimer, J, Mullens, EL, Giorgi, L, Young, F. Safety review of adult clinical trial experience with lamotrigine. Drug Saf. 1998;18:281–296.CrossRefGoogle ScholarPubMed
15.Lamictal [package insert]. Middlesex, UK: GlaxoSmithKline; 2005.Google Scholar
16.Bowden, CL. Valproate. Bipolar Disord. 2003;5:189–202.CrossRefGoogle ScholarPubMed
17.McIntyre, RS, Konarski, JZ. Tolerability profiles of atypical antipsychotics in the treatment of bipolar disorder. J Clin Psychiatry. 2005;66(suppl 3):28–36.Google ScholarPubMed
18.Calabrese, JR, Rapport, DJ, Kimmel, SE, et al.Controlled trials in bipolar I depression: Focus on switch rates and efficacy. Eur Neuropsychopharmacol. 1999;9(suppl 4):S109–S112.CrossRefGoogle ScholarPubMed
19.Howland, RH. Induction of mania with serotonin reuptake inhibitors. J Clin Psychopharmacol. 1996;16:425–427.CrossRefGoogle ScholarPubMed
20.Compton, MT, Nemeroff, CB. The treatment of bipolar depression. J Clin Psychiatry. 2000;61(suppl 9):57–67.Google ScholarPubMed
21.Peet, M. Induction of mania with selective serotonin reuptake inhibitors and tricyclic antidepressants. Br J Psychiatry. 1994;164:549–550.CrossRefGoogle ScholarPubMed
22.Bowden, CL, Calabrese, JR, McElroy, SL, 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
23.Tohen, M, Chengappa, KNR, Suppes, T, et al.Efficacy of olanzapine in combination with valproate or lithium in the treatment of mania in patients partially nonresponsive to valproate or lithium monotherapy. Arch Gen Psychiatry. 2002;59:62–69.CrossRefGoogle ScholarPubMed