PMID- 21240149
OWN - NLM
STAT- MEDLINE
DCOM- 20120302
LR  - 20211020
IS  - 0048-5764 (Print)
IS  - 0048-5764 (Linking)
VI  - 43
IP  - 4
DP  - 2010
TI  - Lamotrigine adjunctive therapy to lithium and divalproex in depressed patients 
      with rapid cycling bipolar disorder and a recent substance use disorder: a 
      12-week, double-blind, placebo-controlled pilot study.
PG  - 5-21
AB  - OBJECTIVE: To pilot the efficacy and safety data of lamotrigine adjunctive 
      therapy to lithium and divalproex in patients with rapid-cycling bipolar disorder 
      (RCBD) and a recent substance use disorder (SUD). METHOD: Structured clinical 
      interviews were used to ascertain DSM-IV diagnosis of RCBD, SUDs, and other Axis 
      I disorders. Patients who did not meet the criteria for a bimodal response after 
      up to 16-weeks of open-label treatment with lithium plus divalproex, as measured 
      by MADRS (Montgomery-Asberg Depression Rating Scale) </= 19, YMRS ( Young Mania 
      Rating Scale) </= 12 and GAF (Global Assessment of Functioning) = 51 for 4 weeks, 
      were randomized to a 12- week, double-blind addition of lamotrigine or placebo to 
      lithium plus divalproex. Primary and secondary outcomes were analyzed with 
      ANCOVA, t-test, or chi-square/Fisher's exact. RESULTS: Of 98 patients enrolled 
      into the study, 36 were randomized to receive lamotrigine (n = 18) or placebo (n 
      +/- 18), and 8 patients per arm completed the study. No patient discontinued due to 
      adverse events. The change in MADRS total score from baseline to endpoint was 
      -9.1 +/- 11.2 in lamotrigine-treated patients versus -4.5 +/- 13.1 in placebo-treated 
      patients (p = 0.27). There were no significant differences in changes in YMRS 
      total scores and rates of response or remission. CONCLUSIONS: Lamotrigine 
      adjunctive therapy was well tolerated in patients previously non-responsive to 
      initial treatment of lithium plus divalproex. A larger study is warranted to 
      determine the efficacy and safety of adjunctive lamotrigine versus placebo in 
      RCBD with a recent SUD.
FAU - Wang, Zuowei
AU  - Wang Z
AD  - Department of Psychiatry, Case Western Reserve University School of Medicine, 
      Cleveland, OH, USA.
FAU - Gao, Keming
AU  - Gao K
FAU - Kemp, David E
AU  - Kemp DE
FAU - Chan, Philip K
AU  - Chan PK
FAU - Serrano, Mary Beth
AU  - Serrano MB
FAU - Conroy, Carla
AU  - Conroy C
FAU - Fang, Yiru
AU  - Fang Y
FAU - Ganocy, Stephen J
AU  - Ganocy SJ
FAU - Findling, Robert L
AU  - Findling RL
FAU - Calabrese, Joseph R
AU  - Calabrese JR
LA  - eng
GR  - P20 MH066054/MH/NIMH NIH HHS/United States
GR  - P20 MH-66054/MH/NIMH NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Psychopharmacol Bull
JT  - Psychopharmacology bulletin
JID - 0101123
RN  - 0 (Antimanic Agents)
RN  - 0 (Lithium Compounds)
RN  - 0 (Placebos)
RN  - 0 (Triazines)
RN  - 614OI1Z5WI (Valproic Acid)
RN  - U3H27498KS (Lamotrigine)
SB  - IM
MH  - Adult
MH  - Analysis of Variance
MH  - Antimanic Agents/adverse effects/*therapeutic use
MH  - Bipolar Disorder/complications/diagnosis/*drug therapy/psychology
MH  - Chi-Square Distribution
MH  - Depression/complications/diagnosis/*drug therapy/psychology
MH  - Double-Blind Method
MH  - Drug Therapy, Combination
MH  - Humans
MH  - Lamotrigine
MH  - Lithium Compounds/adverse effects/*therapeutic use
MH  - Middle Aged
MH  - Ohio
MH  - Pilot Projects
MH  - Placebos
MH  - Psychiatric Status Rating Scales
MH  - Remission Induction
MH  - Substance-Related Disorders/*complications/psychology
MH  - Time Factors
MH  - Treatment Outcome
MH  - Triazines/adverse effects/*therapeutic use
MH  - Valproic Acid/adverse effects/*therapeutic use
PMC - PMC3442254
MID - NIHMS405114
EDAT- 2011/01/18 06:00
MHDA- 2012/03/03 06:00
PMCR- 2012/09/14
CRDT- 2011/01/18 06:00
PHST- 2011/01/18 06:00 [entrez]
PHST- 2011/01/18 06:00 [pubmed]
PHST- 2012/03/03 06:00 [medline]
PHST- 2012/09/14 00:00 [pmc-release]
PST - ppublish
SO  - Psychopharmacol Bull. 2010;43(4):5-21.