PMID- 15708424 OWN - NLM STAT- MEDLINE DCOM- 20050628 LR - 20181201 IS - 0165-0327 (Print) IS - 0165-0327 (Linking) VI - 84 IP - 2-3 DP - 2005 Feb TI - Sustained remission with lamotrigine augmentation or monotherapy in female resistant depressives with mixed cyclothymic-dysthymic temperament. PG - 259-66 AB - BACKGROUND: The treatment of bipolar depression remains problematic. Lamotrigine has been shown in randomized controlled studies to be efficacious in preventing bipolar depression and rapid cycling states. METHODS: Twenty-four women with cyclothymic temperament and refractory depression were recruited from four outpatient sites (three primary care and one psychiatric) and treated with lamotrigine in a naturalistic, open-label study. Temperament was determined by responses on the TEMP-A self-rating scale. Eighteen (75%) of these cyclothymic patients also scored high on the depressive temperament. Eighteen (75%) met DSM-IV criteria for bipolar II disorder. In two thirds of the cases, lamotrigine was add-on therapy to an antidepressant. Response to therapy was assessed using the DSM-IV Global Assessment of Functioning (GAF). LIMITATIONS: This study was naturalistic in design, without controls or blinds. RESULTS: Of the 23 patients who remained in the study, 16 (70%) had significant, sustained responses. Of these 16, 12 (75% of responders, 52% of the total) had remissions (GAF > 80) sustained longer than 12 months. Robust, sustained responses to lamotrigine monotherapy were seen in 4 patients (17%). Seven patients (30%) received no apparent benefit from lamotrigine. CONCLUSIONS: Lamotrigine induced prolonged illness remissions in a substantial number of female patients whose symptoms were both complex and refractory. Most manifested high scores on the cyclothymic and depressive temperaments, and prior refractoriness to multiple antidepressant and antidepressant/mood stabilizer combinations, before remitting with lamotrigine augmentation or monotherapy. FAU - Manning, J Sloan AU - Manning JS AD - From Mood Clinic, Family Medicine Department, University of Tennessee, Memphis, TN, USA. smanning1@triad.rr.com FAU - Haykal, Radwan F AU - Haykal RF FAU - Connor, Pamela D AU - Connor PD FAU - Cunningham, Patricia D AU - Cunningham PD FAU - Jackson, W Clay AU - Jackson WC FAU - Long, Stephanie AU - Long S LA - eng PT - Journal Article PL - Netherlands TA - J Affect Disord JT - Journal of affective disorders JID - 7906073 RN - 0 (Antidepressive Agents) RN - 0 (Triazines) RN - U3H27498KS (Lamotrigine) SB - IM MH - Adult MH - Antidepressive Agents/*administration & dosage/adverse effects MH - Bipolar Disorder/diagnosis/*drug therapy/psychology MH - Cyclothymic Disorder/diagnosis/*drug therapy/psychology MH - Depressive Disorder, Major/diagnosis/*drug therapy/psychology MH - Diagnostic and Statistical Manual of Mental Disorders MH - Drug Therapy, Combination MH - Female MH - Follow-Up Studies MH - Humans MH - Lamotrigine MH - Middle Aged MH - Personality Inventory MH - Temperament MH - Triazines/*administration & dosage/adverse effects EDAT- 2005/02/15 09:00 MHDA- 2005/06/29 09:00 CRDT- 2005/02/15 09:00 PHST- 2003/05/28 00:00 [received] PHST- 2004/01/30 00:00 [accepted] PHST- 2005/02/15 09:00 [pubmed] PHST- 2005/06/29 09:00 [medline] PHST- 2005/02/15 09:00 [entrez] AID - S0165032704000874 [pii] AID - 10.1016/j.jad.2004.01.016 [doi] PST - ppublish SO - J Affect Disord. 2005 Feb;84(2-3):259-66. doi: 10.1016/j.jad.2004.01.016.