If this is not your name, click here.
| | If this is not your name, click here. | | |
| | Contact Us | Order Now | Journals | Bookstore | Register a colleague | | |
| |  CINP: Lamotrigine and Lithium Effective for Complementary Maintenance Therapy of Bipolar Symptoms By Heather Pengelley Special to DG News MONTREAL, QC -- June 26, 2002 -- Lamotrigine and lithium are effective in preventing the return of mania and depression in patients with bipolar I disorder. Important new evidence shows that these mood stabilizers may compliment each other in stabilizing mood swings in patients over time. The findings of two international, prospective, placebo-controlled trials comparing the mood stabilizers, along with a summary and meta-analysis of both maintenance studies, were presented at the 23rd Congress of the Collegium Internationale Neuro-Psychopharmacologicum (CINP). Each study found that in patients with stable bipolar I disorder, lamotrigine was more effective than placebo in preventing the return of depression, while lithium was more effective than placebo in preventing the return of mania. "These are the first positive, placebo-controlled maintenance studies in bipolar disorder in 28 years," said Dr. Joseph Calabrese, of Case Western University, Cleveland, Ohio, United States, leader of an international team of researchers who conducted the meta-analysis. Patients in each trial had recently completed an open-label study of lamotrigine. All had stable bipolar I disorder, were outpatients aged 18 years or older, and had no significant health or thyroid problems. In one trial, 463 patients with bipolar disorder and a recent or current diagnosis of depression, based on DSM-IV criteria, were randomised to lamotrigine 50 mg, 200 mg, or 400 mg/day (221 patients), lithium 0.8 to 1.1 mEq/L (121 patients), or placebo (121 patients) for 18 months. The investigators studied the time to intervention for mood episode, depressive episode, and manic episode. Both lamotrigine and lithium were significantly more effective than placebo in preventing a mood episode (p=0.029). Lamotrigine was significantly more effective than placebo in preventing a depressive episode (p=0.047), while lithium was not (p=0.209). The reverse was true for manic episodes. Lithium was significantly more effective than placebo (p=0.026), while lamotrigine was not (p=0.339). In the other trial, 175 patients with bipolar disorder and a recent diagnosis of mania or hypomania, based on DSM-IV criteria, were randomised to lamotrigine 100 to 400 mg/day (59 patients), lithium 0.8 to 1.1 mEq/L (46 patients), or placebo (70 patients) for 18 months. Again, lamotrigine and lithium were more effective than placebo in preventing a mood disorder (lamotrigine, p=0.018; lithium, p=0.003). The same pattern of efficacy emerged in this trial. Lamotrigine was significantly more effective than placebo in preventing a depressive episode (p=0.015), while lithium was not (p=0.167). To prevent manic episodes, lithium was significantly more effective than placebo (p=0.006), while lamotrigine was not (p=0.280). "In each of the individual studies, the spectrum of efficacy was complementary. Lamotrigine prevented depression but not mania and lithium prevented mania but not depression," Dr. Calabrese noted. "What this basically means is that these drugs should be used together, not alone, in patients with bipolar I disorder," he concluded.
|
