Lamotrigine (Lamictal) has distinct and perhaps complementary mood-stabilizing effects for the treatment of bipolar disorder, according to presentations on May 20 and 21 at the American Psychiatric Association (APA) 155th annual meeting in Philadelphia, Pennsylvania. Other presentations suggest that olanzapine (Zyprexa) enhances the effect of either lithium or valproate, and that rapidly increasing the dose of olanzapine controls agitation in both bipolar disorder and schizophrenia.
“Lamotrigine significantly delayed time to any bipolar episode and time to treatment intervention in some of the longest maintenance studies ever conducted in bipolar disorder,” lead investigator Joseph R. Calabrese, MD, professor of psychiatry at Case Western Reserve University School of Medicine in Cleveland, Ohio, said in a news release.
“The results support the favorable efficacy and safety profile seen in studies of lamotrigine to date, suggesting that it may be a promising treatment for bipolar disorder patients, particularly those experiencing the devastating lows of bipolar depression.”
In 2 large maintenance studies that were prospectively designed to be combined for analysis of treatment outcomes, 1315 currently or recently symptomatic bipolar I patients by DSM-IV criteria were enrolled in the preliminary phase, and 638 of these patients were stabilized and randomized to 18 months of double-blind monotherapy with lamotrigine (n=280; 50-400 mg/day fixed and flexible dose), lithium (n=167; 0.8-1.1 mEq), or placebo (n=191).
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