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Cited by 49Bipolar Disorder and TreatmentTreatment of Major DepressionSchizophrenia research and treatment

Multisite, open-label, prospective trial of lamotrigine for geriatric bipolar depression: a preliminary report

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Sajatovic, Martha, Gildengers, Ariel, Al Jurdi, Rayan K, Gyulai, Laszlo, Cassidy, Kristin A, Greenberg, Rebecca L, Bruce, Martha L, Mulsant, Benoit H +2 more·2011·Bipolar Disorders
DOI 10.1111/j.1399-5618.2011.00923.xPMC PMC3610426
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Abstract

AIMS: This is a multisite, 12-week, open-label trial of lamotrigine augmentation in 57 older adults (≥ 60 years; mean ± SD age = 66.5 ± 6.7 years) with either type I or type II bipolar depression. METHODS: Primary outcome measure was change from baseline on the Montgomery-Åsberg Depression Rating Scale (MADRS). Secondary outcome measures included Hamilton Depression Rating Scale (HAM-D), Clinical Global Impression-Bipolar version (CGI-BP), and the WHO-Disability Assessment Schedule II (WHO-DAS II). The Udvalg for Kliniske Undersøgelser (UKU) was used to assess side effects. RESULTS: A total of 77.2% of the study subjects had bipolar I disorder. The mean (SD) lamotrigine dose was 150.9 (68.5) mg/day. There was significant improvement in the MADRS, HAM-D, CGI-BP, and in most domains on the WHO-DAS II. For patients for whom final MADRS score was available: 31 (57.4%) met remission criteria and 35 (64.8%) met response criteria. There were 19/57 (33.3%) who dropped out of the study prematurely, with 6 dropouts due to adverse events (4 cases of rash, 1 manic switch, and 1 hyponatremia). Two cases of rash were possibly drug related and were resolved with drug discontinuation. The most common UKU adverse effects were reduced sleep duration (n = 14, 24.6%), weight loss (n = 12, 21.1%), increased dream activity (n = 12, 21.1%), polyuria/polydipsia (n = 11, 19.3%), weight gain (n = 9, 15.8%), diminished sexual desire (n = 9, 15.8%), increased sleep (n = 9, 15.8%), lassitude/fatigue (n = 8, 14%), and unsteady gait (n = 8, 14%). No significant changes in electrocardiogram or laboratory tests were observed. CONCLUSIONS: In bipolar depressed elders, lamotrigine was associated with improvement in depression, psychopathology, and functional status. There was a moderate number of adverse events, although relationship of adverse events (particularly falls) to study medication could not be clearly determined in this uncontrolled trial. Controlled studies are needed to further evaluate efficacy and tolerability of lamotrigine therapy in geriatric bipolar depression.

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  1. [22]First MB Spitzer RL Gibbon M Williams JBW Structured Clinical Interview for Axis I DSM-IV Disorders-(SCID) Patient Edition 1996 Biometrics Research Department, New York State Psychiatric Institute New York Version 2.0.
  2. [36]Reitan RM Wolfson D The Halstead-Reitan Neuropsycholgical Test Battery: Therapy and Clinical Interpretation 1985 Neuropsychological Press Tucson

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Authors
Sajatovic, M., Gildengers, A., Al Jurdi, R. K., Gyulai, L., Cassidy, K. A., Greenberg, R. L., Bruce, M. L., Mulsant, B. H., Ten Have, T., & Young, R. C.
Affiliations
  • University Hospitals Cleveland Medical Center (US)
  • University of Pittsburgh (US)
  • University of Pennsylvania (US)
  • Weill Cornell Medicine (US)
  • Centre for Addiction and Mental Health (CA)
Corresponding author
Sajatovic, Martha
ORCID
Venue
Bipolar Disorders
Publisher
Wiley
Published
2011-05
Volume
13
Issue
3
Pages
294-302
ISSN
1398-5647 (ISSN-L)
DOI
10.1111/j.1399-5618.2011.00923.x
PMC
PMC3610426
OpenAlex
W1940801264
Cited by
49
References
40
Citations by year
2026: 1 · 2025: 4 · 2024: 2 · 2023: 4 · 2022: 4 · 2021: 2 · 2020: 3 · 2019: 3 · 2018: 1 · 2017: 7 · 2016: 3 · 2015: 2 · 2014: 2 · 2013: 5 · 2012: 4
FWCI
2.86
Type
journal article
Language
en
Open access
Licence
doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 1584 d)
Locations
  • Bipolar Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • GlaxoSmithKline
  • University of Arkansas
  • Dartmouth College
  • National Institute for Health and Care Research
  • National Institutes of Health
  • U.S. Food and Drug Administration
  • Canadian Institutes of Health Research
  • National Institute of Mental Health (K02MH067028)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords
lamotrigine, bipolar depression, geriatric depression, older adults, bipolar I disorder, adverse drug reactions, rash, hyponatremia, manic switch, functional disability, sleep disorders, weight loss, sexual dysfunction, polyuria and polydipsia, WHO Disability Assessment Schedule
MeSH terms
Lamotrigine, Aged, Aged, 80 and over, Bipolar Disorder, Disability Evaluation, Female, Humans, Male, Middle Aged, Patient Dropouts, Prospective Studies, Psychiatric Status Rating Scales, Time Factors, Triazines, Antimanic Agents

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