Role of lamotrigine in the management of treatment-resistant bipolar II depression: A chart review

Objectives: We,report the results of a retrospective, naturalistic study of lamotrigine in the management of treatment-resistant bipolar II depression. Methods: Hospital charts of 31 patients treated at a mood disorders clinic, who had been on lamotrigine for at least six months after failing to show an adequate response to a combination of two mood stabilizers or a mood stabilizer and an antidepressant, were reviewed using the Clinical Global Impression-Improvement (CGI) rating scale. Results: Patients were seen for an average of 19.4 months following the introduction of lamotrigine. The lamotrigine daily dose ranged from 50-400 mg (mean dose 199.2 mg) as monotherapy or in combination with a mood stabilizer, an atypical antipsychotic, or a sedative/hypnotic drug. Very much improvement was seen in 52% of patients and 32% were considered much improved. Conclusions: These naturalistic data suggest that lamotrigine alone or in combination with other psychotropic drugs was well tolerated and effective in the management treatment-resistant bipolar II depression. Limitations: Retrospective design, small sample size, and lack of a control group. (C) 2008 Elsevier B.V. All rights reserved.