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 .
Adjunctive herbal medicine with carbamazepine for bipolar disorders: A double-blind, randomized, placebo-controlled study.
Chinese herbal medicines possess the therapeutic potential for mood disorders . This double-blind , r and omized , placebo-controlled study was design ed to evaluate the efficacy and side effects of the herbal medicine called Free and Easy W and erer Plus ( FEWP ) as an adjunct to carbamazepine ( CBZ ) in patients with bipolar disorders . One hundred and twenty-four bipolar depressed and 111 manic patients were r and omized to treatment with CBZ alone , CBZ plus FEWP , or equivalent placebo  for 12 weeks . CBZ was initiated at 300mg/day and FEWP was given at a fixed dose of 36g/day . Efficacy measures included the Hamilton Rating Scale for Depression , Montgomery-Asberg Depression Rating Scale , Young Mania Rating Scale , Bech-Rafaelsen Mania Scale , and Clinical Global Impression-Severity ( CGI-S ) .  CBZ monotherapy produced significantly greater improvement on manic measures at week 2 through endpoint and CGI-S of depression at endpoint compared to placebo . CBZ monotherapy also yielded significantly higher clinical response rates than placebo on bipolar depression ( 63.8 % vs. 34.8 % , p=0.044 ) and mania ( 87.8 % vs. 57.1 % , p=0.012 ) . Compared to CBZ monotherapy , adjunctive FEWP with CBZ result ed in significantly better outcomes on the three measures of depression at week 4 and week 8 and significantly greater clinical response rate in depressed subjects ( 84.8 % vs. 63.8 % , p=0.032 ) , but failed to produce significantly greater improvement on manic measures and the response rate in manic subjects . There was a lesser incidence of dizziness and fatigue in the combination therapy compared to CBZ monotherapy . These results suggest that adjunctive FEWP has additive beneficial effects in bipolar patients , particularly for those in depressive phase
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 .