title: Adjunctive treatment for mood stabilization of patients with bipolar I disorder treated with lamotrigine.
abstract: 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.
authors.affiliation: Clinical Development, GlaxoSmithKline, Research Triangle Park, NC 27709, USA. ted.c.spaulding@gsk.com
authors.forename: Theodore
authors.initials: T
authors.lastname: Spaulding
authors.forename: Ronald
authors.initials: R
authors.lastname: Westlund
authors.forename: Christine
authors.initials: C
authors.lastname: Thomason
authors.forename: Robin
authors.initials: R
authors.lastname: White
authors.forename: Rebekkah
authors.initials: R
authors.lastname: Dann
authors.forename: Thomas
authors.initials: T
authors.lastname: Thompson
mesh_terms: 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*
chemical_list: D014151:Anti-Anxiety Agents; D018692:Antimanic Agents; D014227:Triazines; D001569:Benzodiazepines; D000077213:Lamotrigine