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Carbamazepine vs Lithium in the Treatment and Prophylaxis of Mania

Published online by Cambridge University Press:  02 January 2018

R. M. Lusznat
Affiliation:
Department of Psychiatry, Royal South Hants Hospital, Graham Road, Southampton, Hampshire SO9 4PE
D. P. Murphy
Affiliation:
Department of Psychiatry, Royal South Hants Hospital, Graham Road, Southampton, Hampshire SO9 4PE
C. M. H. Nunn*
Affiliation:
Department of Psychiatry, Royal South Hants Hospital, Graham Road, Southampton, Hampshire SO9 4PE
*
Correspondence

Abstract

Fifty-four acutely manic patients were allocated to treatment on a double-blind basis with either carbamazepine or lithium carbonate. The short-term effects of treatment were studied over a period of six weeks and the longer term, prophylactic, effects over a period of up to a year. Additional ‘rescue’ medication was allowed when clinically indicated. There was a high drop-out rate from the trial. Despite this, it appeared that valid comparisons between the two treatments could be made. No statistically significant differences were found, but carbamazepine appeared slightly less effective as a treatment for acute mania and more effective as a prophylactic treatment in this group of patients. Possible predictors of individual responsiveness to each treatment are discussed.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1988 

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References

Arana, G. W., Goff, D. C., Friedman, H., Ornsteen, M. & Greenblatt, D. J. (1986) Does carbamazepine-induced reduction of plasma haloperidol levels worsen psychotic symptoms? American Journal of Psychiatry, 143, 650651.Google Scholar
Ballenger, J. C. & Post, R. M. (1980) Therapeutic effects of carbamazepine in affective illness: a preliminary report. American Journal of Psychiatry, 137, 782790.Google Scholar
Bech, P., Bolwig, T. G., Kramp, P. & Rafaelson, O. J. (1979) The Bech–Rafaelson Mania Scale and the Hamilton Depression Scale: evaluation of homogeneity and inter-observer reliability. Acta Psychiatrica Scandinavica, 59, 420430.Google Scholar
Belmaker, R. H., Lerer, B. & Klein, E. (1984) A comparison of carbamazepine with lithium in excited psychoses. In Anticonvulsants in Affective Disorders (eds Emrich, H. M., Okuma, T. & Muller, A. A. Amsterdam: Elsevier Science Publishers.Google Scholar
Carroll, B. J., Curtis, G. C. & Mendels, J. (1976) Neuroendocrine regulation in depression – 1. Limbic system–adrenocortical dysfunction. Archives of General Psychiatry, 33, 10391044.CrossRefGoogle Scholar
Keisling, R. (1983) Carbamazepine and lithium carbonate in the treatment of refractory affective disorders (letter). Archives of General Psychiatry, 40, 223.Google Scholar
Lerer, B., Moore, N., Meyendorff, E., Suno-Ran, C. & Gershon, S. (1987) Carbamazepine versus lithium in mania: a double-blind study. Journal of Clinical Psychiatry, 48, 8993.Google Scholar
Lipinski, J. F. & Pope, M. G. (1982) Possible synergistic action between carbamazepine and lithium carbonate in the treatment of three acutely manic patients. American Journal of Psychiatry, 139, 948949.Google Scholar
Okuma, T., Kishimoto, A., Inoue, K., Matsumoto, H., Ogura, A., Matsushita, T., Nakao, T. & Ogura, C. (1973) Anti-manic and prophylactic effects of carbamazepine (Tegretol) on manic–depressive psychosis: a preliminary report. Folia Psychiatrica et Neurologica Japanica, 27, 283297.Google ScholarPubMed
Okuma, T., Inanaga, K., Otsuki, S. Sarai, K., Takahashi, R., Hazama, H., Mori, A. & Watanabe, M. (1979) Comparison of the anti-manic efficacy of carbamazepine and chlorpromazine: a double blind controlled study. Psychopharmacology, 66, 211217.CrossRefGoogle Scholar
Placidi, G. F., Lenzi, A., Rampello, E., Andreani, M. F., Cassano, G. B. & Grossi, E. (1984) Long-term double blind study on carbamazepine versus lithium in bipolar and ∗schizoaffective disorder: preliminary results. In: Anticonvulsants in Affective Disorders (eds Emrich, H. M., Okuma, T. & Muller, A. A.). Amsterdam: Elsevier Science Publishers.Google Scholar
Psychological Medicine (1982) Use of the anticonvulsant carbamazepine in primary and secondary affective illness: clinical and theoretical implications. Psychological Medicine, 12, 701704.Google Scholar
Takezaki, M. & Hanaoka, M. (1971) The use of carbamazepine in the control of manic–depressive psychosis and other manic–depressive states (in Japanese). Sheishin-igaku, 13, 173183.Google Scholar
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