The increasing use of anticonvulsants in prophylactic treatment of bipolar disorder

Yang, Yanling; Deng, H.-C.; Wang, Bi‐Hwa

doi:10.1046/j.1440-1819.1998.00405.x

Cited by 7 publications

(4 citation statements)

References 14 publications

(13 reference statements)

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“…Although there are now several available mood stabilizers, 1 lithium is still the drug of first choice for maintenance treatment for bipolar disorder. 2 However, lithium is not effective for all bipolar patients.…”

Section: Introductionmentioning

confidence: 99%

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White matter hyperintensity detected by magnetic resonance imaging and lithium response in bipolar disorder: A preliminary observation

Kato

Fujii

Kamiya

et al. 2000

Psychiatry Clin Neurosci

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The possible relationship between deep white matter hyperintensity (WMHI) lesions detected by magnetic resonance imaging and response to lithium was examined in 16 patients with bipolar disorder who had been under maintenance treatment with lithium for more than 1 year. Bipolar patients who had higher scores of WMHI responded significantly better to lithium (r = 0.57, P < 0.05) than did those who had lower scores. This preliminary result suggests that the presence of WMHI may be associated with a better response to lithium.

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Section: Introductionmentioning

confidence: 99%

“…Bipolar disorder is a socially disabling mental disorder that affects approximately 1% of the population. Although there are now several available mood stabilizers, 1 lithium is still the drug of first choice for maintenance treatment for bipolar disorder. 2 However, lithium is not effective for all bipolar patients.…”

Section: Introductionmentioning

confidence: 99%

White matter hyperintensity detected by magnetic resonance imaging and lithium response in bipolar disorder: A preliminary observation

Kato

Fujii

Kamiya

et al. 2000

Psychiatry Clin Neurosci

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“…Moreover, it was found to be compatible with lithium in the treatment of acute mania in small-scale trials [9,10]. In Taiwan, CBZ has been increasingly used to treat bipolar disorder [11]. Its efficacy for treating acute mania was recently reconfirmed following the completion of large-scale, randomized, placebo-controlled trials in North America using extended-release CBZ [12,13].…”

Section: Introductionmentioning

confidence: 99%

Carbamazepine treatment of bipolar disorder: a retrospective evaluation of naturalistic long-term outcomes

Chen

Lin

2012

BMC Psychiatry

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BackgroundCarbamazepine (CBZ) has been used in the treatment of bipolar disorder, both in acute mania and maintenance therapy, since the early 1970s. Here, we report a follow-up study of CBZ-treated bipolar patients in the Taipei City Psychiatric Centre.MethodsBipolar patients diagnosed according to the DSM-IV system and treated with CBZ at the Taipei City Psychiatric Centre had their charts reviewed to evaluate the efficacy and side effects of this medication during an average follow-up period of 10 years.ResultsA total of 129 bipolar patients (45 males, mean age: 45.7 ± 10.9 year) were included in the analysis of CBZ efficacy used alone (n = 63) or as an add-on after lithium (n = 50) or valproic acid (n = 11), or the both of them (n = 5). The mean age of disease onset was 24.6 ± 9.5 years. The mean duration of CBZ use was 10.4 ± 5.2 year. The mean dose used was 571.3 ± 212.6 mg/day with a mean plasma level of 7.8 ± 5.9 μg/mL. Mean body weight increased from 62.0 ± 13.4 kg to 66.7 ± 13.1 kg during treatment. The frequencies of admission per year before and after CBZ treatment were 0.33 ± 0.46 and 0.14 ± 0.30, respectively. The most common side effects targeted the central nervous system (24%), including dizziness, ataxia and cognitive impairment. Other common side effects were gastrointestinal disturbances (3.6%), tremor (3.6%), skin rash (2.9%), and blurred vision (2.9%). Eighty-eight patients (68.2%) were taking antipsychotics concomitantly. Ninety-six patients (74.4%) needed to use benzodiazepines concomitantly. Sixty-three (48.8%) patients had zero episodes in a 10-year follow-up period, compared to all patients having episodes prior to treatment. Using variable analysis, we found better response to CBZ in males than in females.ConclusionsCBZ is efficacious in the maintenance treatment of bipolar disorder in naturalistic clinical practice, either as monotherapy or in combination with other medications. CBZ is well tolerated by most patients in this patient group.

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“…Women with epilepsy typically require ongoing AED therapy during pregnancy to avoid the potentially adverse effects of seizures on themselves or the developing fetus. AEDs, however, also are used to treat other illnesses, including migraines, chronic pain, and bipolar disorder [Yang et al, 1998; Russo et al, 2002; Pennell, 2004; Grunze, 2008, 2010; Newport et al, 2008; Bowden, 2009; Bramness et al, 2009; Reimers, 2009; Moch, 2010; Wisner et al, 2011]. Some have suggested that considering AED use among only those with epilepsy would underestimate total use by approximately 50% [Pennell, 2004].…”

Section: Introductionmentioning

confidence: 99%

Influencing clinical practice regarding the use of antiepileptic medications during pregnancy: Modeling the potential impact on the prevalences of spina bifida and cleft palate in the United States

Gilboa

Broussard

Devine

et al. 2011

American J of Med Genetics Pt C

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Selected antiepileptic drugs (AEDs) increase the risk of birth defects. To assess the impact of influencing AED prescribing practices on spina bifida and cleft palate we searched the literature for estimates of the association between valproic acid or carbamazepine use during pregnancy and these defects and summarized the associations using meta-analyses. We estimated distributions of the prevalence of valproic acid and carbamazepine use among women of childbearing age based on analyses of four data sets. We estimated the attributable fractions and the number of children born with each defect that could be prevented annually in the United States if valproic acid and carbamazepine were not used during pregnancy. The summary odds ratio estimate for the association between valproic acid and spina bifida was 11.9 (95% uncertainty interval (UI): 4.0-21.2); for valproic acid and cleft palate 5.8 (95% UI: 3.3-9.5); for carbamazepine and spina bifida 3.6 (95% UI: 1.3-7.8); and for carbamazepine and cleft palate 2.4 (95% UI: 1.1-4.5) in the United States. Approximately 40 infants (95% UI: 10-100) with spina bifida and 35 infants (95% UI: 10-70) with cleft palate could be born without these defects each year if valproic acid were not used during pregnancy; 5 infants (95% UI: 0-15) with spina bifida and 5 infants (95% UI: 0-15) with cleft palate could be born without these defects each year if carbamazepine were not used during pregnancy. This modeling approach could be extended to other medications to estimate the impact of translating pharmacoepidemiologic data to evidence-based prenatal care practice.

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The increasing use of anticonvulsants in prophylactic treatment of bipolar disorder

Cited by 7 publications

References 14 publications

White matter hyperintensity detected by magnetic resonance imaging and lithium response in bipolar disorder: A preliminary observation

White matter hyperintensity detected by magnetic resonance imaging and lithium response in bipolar disorder: A preliminary observation

Carbamazepine treatment of bipolar disorder: a retrospective evaluation of naturalistic long-term outcomes

Influencing clinical practice regarding the use of antiepileptic medications during pregnancy: Modeling the potential impact on the prevalences of spina bifida and cleft palate in the United States

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