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New data on the use of lithium, divalproate, and lamotrigine in rapid cycling bipolar disorder

  • JR Calabrese, DJ Rapport (a1), EA Youngstrom (a1), K. Jackson (a1), S. Bilali (a1) and RL Findling (a1)...

Abstract

The rapid cycling variant of bipolar disorder is defined as the occurrence of four periods of either manic or depressive illness within 12 months. Patients suffering from this variant of bipolar disorder have an unmet need for effective treatment. This review examines two major studies in an attempt to update understanding of the current therapies available to treat rapid cycling patients. The first trial compares lamotrigine versus placebo in 182 patients studied for 6 months. The second is a recently completed, 20-month trial comparing divalproate and lithium in 60 patients. Both trials had a double-blind, randomized parallel-group design. The data from the latter study indicate that there are no large differences in efficacy between lithium and divalproate in the long-term treatment of rapid cycling bipolar disorder. In addition, lamotrigine has the potential to complement the spectrum of lithium and divalproate through its greater efficacy for depressive symptoms.

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*Corresponding author. E-mail address: Joseph.Calabrese@uhhs.com (J.R. Calabrese).

References

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[1]Calabrese, JR, Delucchi, GASpectrum of efficacy of valproate in 55 patients with rapid cycling bipolar disorder. Am J Psychiatry 1990; 147:431434.
[2]Calabrese, JR, Rapport, DJ, Findling, RL, Shelton, MD, Kimmel, SERapid-cycling bipolar disorder. Marneros, AAngst, JBipolar disorders. Hundred years after manic-depressive insanity 2000 Kluwer Academic Publishers Dordrecht; 89109.
[3]Calabrese, JR, Suppes, T, Bowden, CL, Sachs, GS, Swann, AC, McElroy, SLet al.A double-blind, placebo-controlled, prophylaxis study of lamotrigine in rapid cycling bipolar disorder. J Clin Psychiatry 2000; 61:841850.
[4]Calabrese, JR, Shelton, MD, Rapport, DJ, Kujawa, M, Kimmel, SE, Caban, SCurrent research on rapid cycling bipolar disorder and its treatment. J Affect Disord. 2001; 67:241255.
[5]Calabrese, JR, Shelton, MD, Rapport, DJ, Youngstrom, EA, Jackson, K, Bilali, Set al.A 20-month double-blind, maintenance trial of lithium vs. divalproex in rapid cycling bipolar disorder. Am J Psychiatry 2005 (in press)

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New data on the use of lithium, divalproate, and lamotrigine in rapid cycling bipolar disorder

  • JR Calabrese, DJ Rapport (a1), EA Youngstrom (a1), K. Jackson (a1), S. Bilali (a1) and RL Findling (a1)...

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New data on the use of lithium, divalproate, and lamotrigine in rapid cycling bipolar disorder

  • JR Calabrese, DJ Rapport (a1), EA Youngstrom (a1), K. Jackson (a1), S. Bilali (a1) and RL Findling (a1)...
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