The Effect of Carbamazepine and Lithium on Remission from Affective Illness

Watkins, Sarah E.; Callender, Kay; Thomas, D R; Tidmarsh, S. F.; Shaw, DavidM.

doi:10.1192/bjp.150.2.180

Cited by 97 publications

(47 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It would have been difficult to carry out a blind study over 2.5 years with two substances that present a clearly different side effect profile. In the study on lithium and carbamazepine of Watkins et al [43] blindness could not be kept, and there has been serious doubt in the validity of the double-blind design in long-term trials [44]. In our study, it cannot be excluded that because of the more recent introduction of carbamazepine as a mood stabilizer, the physicians were less confident in the efficacy of carbamazepine as compared to lithium.…”

Section: Discussionmentioning

confidence: 43%

Differential Efficacy of Lithium and Carbamazepine in the Prophylaxis of Bipolar Disorder: Results of the MAP Study

Kleindienst¹,

Greil

2000

Neuropsychobiology

105

View full text Add to dashboard Cite

In a randomized clinical trial with an observation period of 2.5 years, the differential efficacy of lithium versus carbamazepine was compared in 171 bipolar patients (DSM-IV). In order to investigate the efficacy of the two drugs in clearly defined subsamples, a series of subgroup analyses was carried out. First, patients with a bipolar I disorder (n = 114) were analyzed separately. In these patients, lithium was superior to carbamazepine. In contrast, carbamazepine was at least equally as efficacious as lithium in the subsample of patients with bipolar II disorder or bipolar disorder not otherwise specified (n = 57). In a second analysis on differential efficacy, the whole sample was subdivided into a classical subgroup (bipolar I patients without mood-incongruent delusions and without comorbidity; n = 67) and a nonclassical subgroup including all other patients (n = 104). Classical bipolar patients had a significantly lower hospitalization rate under lithium than under carbamazepine prophylaxis (26 vs. 62%, p = 0.012). For the nonclassical group, a tendency in favor of carbamazepine was found. In a third step, we analyzed the impact of episode sequence on differential efficacy. In a global view, the episode sequence prior to the index episode was not correlated to differential efficacy. Our results might, however, indicate that patients with an episode sequence of mania-depression-free interval responded better to lithium. Besides differential efficacy, suicidal behavior and patients’ satisfaction with treatment were investigated. Regarding suicidal behavior, a trend in favor of lithium was found. The data on patients’ satisfaction were significantly in favor of carbamazepine. In conclusion, lithium appears to be superior to carbamazepine in classical bipolar cases and might have additional impact on proneness to suicide. The distinctly larger group of patients with nonclassical features might profit more from carbamazepine which seems to be well accepted by the patients. Hence, treatment alternatives to lithium are desirable for the majority of bipolar patients.

show abstract

Section: Discussionmentioning

confidence: 43%

Differential Efficacy of Lithium and Carbamazepine in the Prophylaxis of Bipolar Disorder: Results of the MAP Study

Kleindienst¹,

Greil

2000

Neuropsychobiology

105

View full text Add to dashboard Cite

show abstract

“…Several controlled studies corroborated carbamazepine's effectiveness in the acute treatment of mania and perhaps prophylaxis of the disorder (Okuma et al 1979(Okuma et al , 1990Coxhead et al 1992;Lusznat et al 1988;Small et al 1991;Watkins et al 1987). Most studies found it to be comparable to lithium in effectiveness, except for three studies (Okuma et al 1981;Lerer et al 1987;Watkins et al 1987).…”

Section: Carbamazepinementioning

confidence: 86%

“…Most studies found it to be comparable to lithium in effectiveness, except for three studies (Okuma et al 1981;Lerer et al 1987;Watkins et al 1987). However, for prophylactic treatment, according to a recent meta-analysis of this literature (Dardennes et al 1995), the effectiveness of carbamazepine remains to be established.…”

Section: Carbamazepinementioning

confidence: 99%

The Lithium Ion: A Foundation for Psychopharmacological Specificity

Soares

Gershon

1998

Neuropsychopharmacology

View full text Add to dashboard Cite

“…When comparing these results to other studies we were confronted with the fact that our patients did somewhat better than those reported by other investigators [10,12,16,17], This might be due to the fact that only about 25% of our sample had been Li nonresponders, a group of patients that clearly prevailed in other studies. It could be argued that Li nonresponders are also less likely to respond to CBZ, and thus show less treatment response than our group consisting mainly of prophylaxis-naive patients.…”

Section: Discussionmentioning

confidence: 41%

The Role of Carbamazepine in the Prophylaxis of Unipolar Depression

et al. 1993

View full text Add to dashboard Cite

The prophylaxis of unipolar depression is still a controversial subject. Some authors prefer lithium, others maintenance treatment with antidepressants. The role of carbamazepine remains unclear. Few patients have been described in the literature, and most are lithium nonresponders or rapid cyclers. In an open-label naturalistic study, 15 patients suffering from unipolar depression (DSM-III, 296.2, 296.3) and receiving long-term prophylaxis with carbamazepine were followed for 5 years. Four had been pretreated with lithium without satisfactory effects, 11 were prophylaxis naive. The mean time span patients received carbamazepine was 49.5 months. 73% of the patients gained substantial profit from carbamazepine. Side effects were infrequent.

show abstract

The Effect of Carbamazepine and Lithium on Remission from Affective Illness

Abstract: Times in remission from affective illness were prolonged during treatment with lithium carbonate and carbamazepine, but lithium was the more effective. Similar global scores for the two drugs suggested that other factors may determine their acceptability.

Cited by 97 publications

References 9 publications

Differential Efficacy of Lithium and Carbamazepine in the Prophylaxis of Bipolar Disorder: Results of the MAP Study

Differential Efficacy of Lithium and Carbamazepine in the Prophylaxis of Bipolar Disorder: Results of the MAP Study

The Lithium Ion: A Foundation for Psychopharmacological Specificity

The Role of Carbamazepine in the Prophylaxis of Unipolar Depression

Contact Info

Product

Resources

About