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 .
Levetiracetam in the management of bipolar depression: a randomized, double-blind, placebo-controlled trial.
OBJECTIVE To study the efficacy of adjunctive levetiracetam therapy compared with placebo in the treatment of subjects with depression with bipolar disorder . METHOD This double-blind , placebo-controlled clinical trial r and omly assigned out patients with bipolar disorder type I and type II who were experiencing a major depressive episode ( Structured Clinical Interview for DSM-IV Axis I Disorders-Clinician Version criteria ) to treatment with either placebo or adjunctive levetiracetam ( up to 2,500 mg/d flexibly dosed ) for 6 weeks . The subjects were recruited from October 2005 to June 2008 . The primary efficacy measure was mean change from baseline to week 6 in the Hamilton Depression Rating Scale ( 21-item ) . Secondary efficacy assessment s included the Montgomery-Åsberg Depression Rating Scale , the Beck Depression Inventory , the Clinical Global Impressions-Bipolar Version scale , the Hamilton Anxiety Rating Scale , and the Young Mania Rating Scale . RESULTS Of 42 subjects r and omly assigned to placebo or drug , 32 received at least 1 postbaseline assessment and thus were included in the analysis . The mean ( SD ) levetiracetam daily dose at endpoint evaluation was 1,132 ( 425 ) mg/d . There was no significant difference in the mean change from baseline to week 6 in the Hamilton Depression Rating Scale scores for levetiracetam compared with placebo . There were no significant differences in any of the secondary outcome measures . CONCLUSIONS Levetiracetam adjunctive therapy was not superior to placebo in the short-term treatment of subjects with depression with bipolar disorder in the population studied . TRIAL REGISTRATION Clinical trials.gov Identifier : NCT00566150
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 .