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Sustained remission with lamotrigine augmentation or monotherapy in female resistant depressives with mixed cyclothymic-dysthymic temperament.
J Affect Disord. 2005 Feb; 84(2-3):259-66.JA

Abstract

BACKGROUND

The treatment of bipolar depression remains problematic. Lamotrigine has been shown in randomized controlled studies to be efficacious in preventing bipolar depression and rapid cycling states.

METHODS

Twenty-four women with cyclothymic temperament and refractory depression were recruited from four outpatient sites (three primary care and one psychiatric) and treated with lamotrigine in a naturalistic, open-label study. Temperament was determined by responses on the TEMP-A self-rating scale. Eighteen (75%) of these cyclothymic patients also scored high on the depressive temperament. Eighteen (75%) met DSM-IV criteria for bipolar II disorder. In two thirds of the cases, lamotrigine was add-on therapy to an antidepressant. Response to therapy was assessed using the DSM-IV Global Assessment of Functioning (GAF).

LIMITATIONS

This study was naturalistic in design, without controls or blinds.

RESULTS

Of the 23 patients who remained in the study, 16 (70%) had significant, sustained responses. Of these 16, 12 (75% of responders, 52% of the total) had remissions (GAF > 80) sustained longer than 12 months. Robust, sustained responses to lamotrigine monotherapy were seen in 4 patients (17%). Seven patients (30%) received no apparent benefit from lamotrigine.

CONCLUSIONS

Lamotrigine induced prolonged illness remissions in a substantial number of female patients whose symptoms were both complex and refractory. Most manifested high scores on the cyclothymic and depressive temperaments, and prior refractoriness to multiple antidepressant and antidepressant/mood stabilizer combinations, before remitting with lamotrigine augmentation or monotherapy.

Authors+Show Affiliations

From Mood Clinic, Family Medicine Department, University of Tennessee, Memphis, TN, USA. smanning1@triad.rr.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15708424

Citation

Manning, J Sloan, et al. "Sustained Remission With Lamotrigine Augmentation or Monotherapy in Female Resistant Depressives With Mixed Cyclothymic-dysthymic Temperament." Journal of Affective Disorders, vol. 84, no. 2-3, 2005, pp. 259-66.
Manning JS, Haykal RF, Connor PD, et al. Sustained remission with lamotrigine augmentation or monotherapy in female resistant depressives with mixed cyclothymic-dysthymic temperament. J Affect Disord. 2005;84(2-3):259-66.
Manning, J. S., Haykal, R. F., Connor, P. D., Cunningham, P. D., Jackson, W. C., & Long, S. (2005). Sustained remission with lamotrigine augmentation or monotherapy in female resistant depressives with mixed cyclothymic-dysthymic temperament. Journal of Affective Disorders, 84(2-3), 259-66.
Manning JS, et al. Sustained Remission With Lamotrigine Augmentation or Monotherapy in Female Resistant Depressives With Mixed Cyclothymic-dysthymic Temperament. J Affect Disord. 2005;84(2-3):259-66. PubMed PMID: 15708424.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sustained remission with lamotrigine augmentation or monotherapy in female resistant depressives with mixed cyclothymic-dysthymic temperament. AU - Manning,J Sloan, AU - Haykal,Radwan F, AU - Connor,Pamela D, AU - Cunningham,Patricia D, AU - Jackson,W Clay, AU - Long,Stephanie, PY - 2003/05/28/received PY - 2004/01/30/accepted PY - 2005/2/15/pubmed PY - 2005/6/29/medline PY - 2005/2/15/entrez SP - 259 EP - 66 JF - Journal of affective disorders JO - J Affect Disord VL - 84 IS - 2-3 N2 - BACKGROUND: The treatment of bipolar depression remains problematic. Lamotrigine has been shown in randomized controlled studies to be efficacious in preventing bipolar depression and rapid cycling states. METHODS: Twenty-four women with cyclothymic temperament and refractory depression were recruited from four outpatient sites (three primary care and one psychiatric) and treated with lamotrigine in a naturalistic, open-label study. Temperament was determined by responses on the TEMP-A self-rating scale. Eighteen (75%) of these cyclothymic patients also scored high on the depressive temperament. Eighteen (75%) met DSM-IV criteria for bipolar II disorder. In two thirds of the cases, lamotrigine was add-on therapy to an antidepressant. Response to therapy was assessed using the DSM-IV Global Assessment of Functioning (GAF). LIMITATIONS: This study was naturalistic in design, without controls or blinds. RESULTS: Of the 23 patients who remained in the study, 16 (70%) had significant, sustained responses. Of these 16, 12 (75% of responders, 52% of the total) had remissions (GAF > 80) sustained longer than 12 months. Robust, sustained responses to lamotrigine monotherapy were seen in 4 patients (17%). Seven patients (30%) received no apparent benefit from lamotrigine. CONCLUSIONS: Lamotrigine induced prolonged illness remissions in a substantial number of female patients whose symptoms were both complex and refractory. Most manifested high scores on the cyclothymic and depressive temperaments, and prior refractoriness to multiple antidepressant and antidepressant/mood stabilizer combinations, before remitting with lamotrigine augmentation or monotherapy. SN - 0165-0327 UR - https://www.unboundmedicine.com/medline/citation/15708424/Sustained_remission_with_lamotrigine_augmentation_or_monotherapy_in_female_resistant_depressives_with_mixed_cyclothymic_dysthymic_temperament_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165032704000874 DB - PRIME DP - Unbound Medicine ER -