Adjunctive treatment for mood stabilization of patients with bipolar I disorder treated with lamotrigine.
OBJECTIVE
To describe the effect of supplemental psychotropic medications, specifically anxiolytics with sedative/hypnotics (ASH) combined with lamotrigine (LTG) on stabilization of symptoms in patients with bipolar I disorder.


METHODS
Symptomatic patients participating in two LTG maintenance trials were classified post-hoc as those initiating LTG as monotherapy (n=313) or as adjunctive therapy (n=814) and further characterized by supplemental add-on therapies received during an open-label treatment phase. Patients were considered stabilized if they reached a stable dose of LTG monotherapy (100-200 mg/day) and had a Clinical Global Impressions-Severity scale score <3 for at least 4 weeks. Stabilization rates were compared across initial- and supplemental-treatment groups.


RESULTS
Patients who initiated and were maintained on LTG monotherapy were stabilized at a slightly higher rate compared with those taking LTG adjunctive therapy (55% vs 48%; P=.080). Stabilization rates were numerically higher for LTG monotherapy patients who later received only ASH as supplemental medication compared with LTG monotherapy throughout, but this difference was not significant (66% vs 55%; P=.271). Stabilization rates were significantly higher for monotherapy patients who later received ASH alone versus other psychotropic medications (66% vs 28%; P=.001). For patients initiating LTG as adjunctive therapy, adding ASH alone resulted in significantly higher stabilization rates than adding another psychotropic medication (62% vs 33%; P<.001).


CONCLUSIONS
LTG and adjunctive treatment with ASH may be useful in the treatment of acute mood symptoms in patients with bipolar I disorder.
Spaulding
Theodore
T
Clinical Development, GlaxoSmithKline, Research Triangle Park, NC 27709, USA. ted.c.spaulding@gsk.com
Westlund
Ronald
R
Thomason
Christine
C
White
Robin
R
Dann
Rebekkah
R
Thompson
Thomas
T
D000328:Adult; D000339:Affect; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D018692:Antimanic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D014227:Triazines / Q000627:therapeutic use*
D014151:Anti-Anxiety Agents; D018692:Antimanic Agents; D014227:Triazines; D001569:Benzodiazepines; D000077213:Lamotrigine