Asunto(s)
Anticonvulsivantes/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Ácidos Nipecóticos/uso terapéutico , Adulto , Anticonvulsivantes/administración & dosificación , Trastorno Bipolar/prevención & control , Trastorno Bipolar/psicología , Esquema de Medicación , Aprobación de Drogas , Quimioterapia Combinada , Femenino , Humanos , Ácidos Nipecóticos/administración & dosificación , Psicotrópicos/administración & dosificación , Psicotrópicos/uso terapéutico , Prevención Secundaria , Tiagabina , Estados Unidos , United States Food and Drug AdministrationRESUMEN
Four anticonvulsant medications (carbamazepine, valproate, gabapentin and lamotrigine) have received attention in the psychiatric literature as efficacious treatment for bipolar disorder, either as monotherapy or as adjunctive agents. Although two earlier reports in 1993 suggested that primidone may also be helpful for bipolar disorder, this older anticonvulsant has not been evaluated in any subsequent studies to confirm these earlier findings. In the present prospective open study, 26 patients with refractory bipolar disorder were treated with primidone as an adjunctive therapy. Eight (31%) patients experienced a persistent positive therapeutic effect. Five (19%) patients were considered partial or temporary responders to primidone. The remaining 13 patients (50%) were considered treatment failures. Although a 31% response rate is considered modest in most psychotropic medication studies, the authors believe that this success rate is significant in this refractory patient population and should provide impetus for future more scientific studies to confirm the preliminary findings of this open trial.
Asunto(s)
Anticonvulsivantes/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Primidona/uso terapéutico , Adulto , Atención Ambulatoria , Antipsicóticos/uso terapéutico , Trastorno Bipolar/psicología , Esquema de Medicación , Quimioterapia Combinada , Femenino , Humanos , Litio/uso terapéutico , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Insuficiencia del Tratamiento , Resultado del Tratamiento , Ácido Valproico/uso terapéuticoRESUMEN
This report describes the results of maintenance treatment with gabapentin in 18 previously refractory Bipolar Disorder patients who initially responded to augmentation with gabapentin during the acute phase of their therapy. Seven of the original 18 patients (39%) have continued to experience benefit from maintenance gabapentin treatment. Only three patients had to discontinue the gabapentin because of side effects. None of the 18 patients experienced an obvious significant adverse drug-drug interaction. Five of the patients discontinued gabapentin because of diminished clinical efficacy after a significant period of positive therapeutic effect. The results of this small open study suggest that gabapentin may be effective as an augmenting agent in the maintenance phase of treatment of some bipolar spectrum patients.