Ginsberg Lawrence D
Red Oak Psychiatry Associates, Houston, TX 77090, USA.
Ann Clin Psychiatry. 2006;18 Suppl 1:31-4. doi: 10.1080/10401230600653452.
Patients with bipolar disorder do not respond to the same therapy in the same way. This potentially necessitates the trial of various treatment modalities in a patient until the illness can be successfully controlled.
Medical histories from 187 patients were reviewed to obtain information on efficacy when patients were switched from their initial drug therapy-immediate-release (IR) or extended-release (ER) carbamazepine (CBZ) tablets, valproic acid, lamotrigine, lithium, olanzapine, and oxcarbazepine-to beaded CBZ extended-release capsules (CBZ-ERC) (Shire, Wayne, PA, USA). Clinical Global Impression-Severity and Clinical Global Impression-Improvement scores were used to assess severity of illness, and response and relapse rates, respectively.
The overall response rate was 79.7%. The greatest percentage of responders to CBZ-ERC treatment was seen in patients originally on lithium (90.5%), followed by those initially treated with oxcarbazepine (84.8%), olanzapine (81.5%), lamotrigine (77.8%), valproic acid (75.4%), and IR or ER CBZ tablets (74.2%). The overall relapse rate was 38.2%. Patients on lithium had the highest relapse rate (52.6%), followed by those on olanzapine (50.0%), valproic acid (34.9%), IR or ER CBZ tablets (34.8%), oxcarbazepine (32.1%), and lamotrigine (28.6%). Adverse events were minimal, with nausea, dizziness, and somnolence being the most frequent.
The encouraging treatment response and adverse event profile observed in this retrospective analysis suggest that CBZ-ERC is an efficacious agent for the treatment of patients with bipolar disorder switched from other psychotropic agents.
