Findings were inconclusive for lamotrigine and carbamazepine although overall lamotrigine may have a beneficial but modest effect .
Negative results were found for levetiracetam and gabapentin but the evidence base on these agents is scant .
All anticonvulsants were generally well tolerated .
No double-blind RCTs were found for the use of other anticonvulsants such as oxcarbazepine , licarbazepine , zonisamide , retigabine , pregabalin , tiagabine , felbamate and vigabatrine in the acute treatment of bipolar depression .
To sum up , taking into consideration the efficacy and tolerability profiles of anticonvulsants , current evidence supports the use of divalproex and lamotrigine in the treatment of acute bipolar depression .
Despite the high morbidity and mortality associated with bipolar depression , the optimal treatment for this phase is still a matter of debate .
The aim of the current review was to provide up date d evidence about the efficacy and tolerability of anticonvulsants in the treatment of acute bipolar depression .
A prospective investigation of the natural history of the long-term weekly symptomatic status of bipolar II disorder.
BACKGROUND This is the first prospect i ve longitudinal study , to our knowledge , of the natural history of the weekly symptomatic status of bipolar II disorder ( BP-II ) . METHODS Weekly affective symptom status ratings for 86 patients with BP-II were based on interviews conducted at 6- or 12-month intervals during a mean of 13.4 years of prospect i ve follow-up . Percentage of weeks at each symptom severity level and the number of shifts in symptom status and polarity were examined . Predictors of chronicity for BP-II were evaluated using new chronicity measures . Chronicity was also analyzed in relation to the percentage of follow-up weeks with different types of somatic treatment . RESULTS Patients with BP-II were symptomatic 53.9 % of all follow-up weeks : depressive symptoms ( 50.3 % of weeks ) dominated the course over hypomanic ( 1.3 % of weeks ) and cycling/mixed ( 2.3 % of weeks ) symptoms . Subsyndromal , minor depressive , and hypomanic symptoms combined were 3 times more common than major depressive symptoms . Longer intake episodes , a family history of affective disorders , and poor previous social functioning predicted greater chronicity . Prescribed somatic treatment did not correlate significantly with symptom chronicity .  Patients with BP-II of brief ( 2 - 6 days ) vs longer ( > or = 7 days ) hypomanias were not significantly different on any measure . CONCLUSIONS The longitudinal symptomatic course of BP-II is chronic and is dominated by depressive rather than hypomanic or cycling/mixed symptoms . Symptom severity fluctuates frequently within the same patient over time , involving primarily symptoms of minor and subsyndromal severity . Longitudinally , BP-II is expressed as a dimensional illness involving the full severity range of depressive and hypomanic symptoms . Hypomania of long or short duration in BP-II seems to be part of the same disease process
Findings were inconclusive for lamotrigine and carbamazepine although overall lamotrigine may have a beneficial but modest effect .
Negative results were found for levetiracetam and gabapentin but the evidence base on these agents is scant .
All anticonvulsants were generally well tolerated .
No double-blind RCTs were found for the use of other anticonvulsants such as oxcarbazepine , licarbazepine , zonisamide , retigabine , pregabalin , tiagabine , felbamate and vigabatrine in the acute treatment of bipolar depression .
To sum up , taking into consideration the efficacy and tolerability profiles of anticonvulsants , current evidence supports the use of divalproex and lamotrigine in the treatment of acute bipolar depression .
Despite the high morbidity and mortality associated with bipolar depression , the optimal treatment for this phase is still a matter of debate .
The aim of the current review was to provide up date d evidence about the efficacy and tolerability of anticonvulsants in the treatment of acute bipolar depression .