New data on the use of lithium, divalproate, and lamotrigine in rapid cycling bipolar disorder.
The rapid cycling variant of bipolar disorder is defined as the occurrence of four periods of either manic or depressive illness within 12 months. Patients suffering from this variant of bipolar disorder have an unmet need for effective treatment. This review examines two major studies in an attempt to update understanding of the current therapies available to treat rapid cycling patients. The first trial compares lamotrigine versus placebo in 182 patients studied for 6 months. The second is a recently completed, 20-month trial comparing divalproate and lithium in 60 patients. Both trials had a double-blind, randomized parallel-group design. The data from the latter study indicate that there are no large differences in efficacy between lithium and divalproate in the long-term treatment of rapid cycling bipolar disorder. In addition, lamotrigine has the potential to complement the spectrum of lithium and divalproate through its greater efficacy for depressive symptoms.
Calabrese
J R
JR
Case Western Reserve University School of Medicine, University Hospitals of Cleveland, 11400 Euclid Avenue, Suite 200, Cleveland, OH 44106, USA. Joseph.Calabrese@uhhs.com
Rapport
D J
DJ
Youngstrom
E A
EA
Jackson
K
K
Bilali
S
S
Findling
R L
RL
D018692:Antimanic Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy*; D006801:Humans; D000077213:Lamotrigine; D016651:Lithium Carbonate / Q000627:therapeutic use*; D010507:Periodicity; D016032:Randomized Controlled Trials as Topic; D014227:Triazines / Q000627:therapeutic use*; D014635:Valproic Acid / Q000627:therapeutic use*
D018692:Antimanic Agents; D014150:Antipsychotic Agents; D014227:Triazines; D016651:Lithium Carbonate; D014635:Valproic Acid; D000077213:Lamotrigine