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 .
Long-term outcome of bipolar depressed patients receiving lamotrigine as add-on to lithium with the possibility of the addition of paroxetine in nonresponders: a randomized, placebo-controlled trial with a novel design.
OBJECTIVE In two previous manuscripts , we described the efficacy of lamotrigine versus placebo as add-on to lithium ( followed by the addition of paroxetine in nonresponders ) in the short-term treatment of bipolar depression . In this paper we describe the long-term ( 68 weeks ) outcome of that study . METHODS A total of 124 bipolar depressed patients receiving lithium  were r and omized to addition of lamotrigine or placebo . After eight weeks , paroxetine was added to nonresponders for another eight weeks . Responders continued medication and were followed for up to 68 weeks or until a relapse or recurrence of a depressive or manic episode . RESULTS After eight weeks , the addition of lamotrigine to lithium was significantly more efficacious than addition of placebo , while after addition of paroxetine in nonresponders both groups further improved with no significant difference between groups at week 16 . During follow-up the efficacy of lamotrigine was maintained : time to relapse or recurrence was longer for the lamotrigine group [ median time 10.0 months ( confidence interval : 1.1 - 18.8 ) ] versus the placebo group [ 3.5 months ( confidence interval : 0.7 - 7.0 ) ] . CONCLUSION In patients with bipolar depression , despite continued use of lithium , addition of lamotrigine revealed a continued benefit compared to placebo throughout the entire study
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 .