A review of the evidence for carbamazepine and oxcarbazepine in the treatment of bipolar disorder.
Bipolar disorder is a recurrent lifelong condition associated with significant morbidity and mortality. The main goals of treatment are the acute management of manic/depressive episodes and the prevention of recurrence. Mood stabilizers are the basis of most treatment regimens. Although lithium is the classical mood stabilizer, dissatisfaction with its efficacy and tolerability has led to increased use of other mood- stabilizing agents, including anticonvulsants. Newer anticonvulsants such as oxcarbazepine may offer improved tolerability and fewer drug-drug interactions compared to older drugs like carbamazepine. A search of the literature shows that data from controlled clinical studies support the efficacy of carbamazepine in treating acute mania and as maintenance therapy. In addition, a growing body of data for oxcarbazepine suggests that this newer agent may have a similar efficacy profile to carbamazepine, with improved tolerability. This review presents a balanced selection of the key studies on carbamazepine and oxcarbazepine in bipolar disorder.
Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch at Galveston, TX 77555-0188, USA. rohirsch@utmb.edu
Robert M A
RM
Hirschfeld
Siegfried
S
Kasper
D000208:Acute Disease; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000517:prevention & control / Q000523:psychology; D002220:Carbamazepine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D018849:Controlled Clinical Trials as Topic; D017281:Cost of Illness; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology; D006801:Humans; D000078330:Oxcarbazepine; D011569:Psychiatric Status Rating Scales
D000927:Anticonvulsants; D002220:Carbamazepine; D000078330:Oxcarbazepine