Lamotrigine in the immediate treatment of outpatients with depersonalization disorder without psychiatric comorbidity: randomized, double-blind, placebo-controlled study.

OBJECTIVE: Depersonalization disorders (DPDs) are highly prevalent in population. However, the effect of lamotrigine on outpatients with DPD without psychiatric comorbidity has not been studied in a double-blind placebo-controlled design. METHOD: Eighty patients (all men) were washed out from all medications. Each patient was randomized either to receive lamotrigine (40 patients) for 12 weeks or matched on placebo (40 patients) in a double-blind manner. Eligible participants, in addition to meeting the criteria for DPD from Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, were required to be between 18 and 65 years. Response was defined as a 50% reduction in the Cambridge Depersonalization Scale. Response effects with lamotrigine and placebo were compared by using analysis of variance and χ² tests. Six patients did not return for at least 1 subsequent assessment, and 74 patients dropped out (36 taking lamotrigine and 38 taking placebo) in the valuables study group. RESULTS: Of the 36 lamotrigine-treated participants, 26 responded by 12 weeks versus 6 of the 38 placebo-treated participants (P < 0.001). The most common and problematic adverse effect in the lamotrigine group was rash. CONCLUSIONS: The authors believe this to be the first double-blind placebo-controlled randomization study to test the efficacy of lamotrigine in the management of outpatients with DPDs. These need to be replicated in a larger study group.

Valproate treatment of acute alcohol hallucinosis: a double-blind, placebo-controlled study.

AIMS: The aim of this study was to compare the efficacy and safety of valproate (Depakine-Chrono) versus placebo for the treatment of acute alcohol hallucinosis. METHODS: 10 days' randomized, double-blind, parallel study was conducted; 40 patients with an ICD-10 diagnosis of acute alcohol hallucinosis were randomized to valproate (Depakine-Chrono) 3000 mg/day (n = 20) or placebo (n = 20). The primary efficacy measure was the Clinical Global Improvement (CGI) and the Positive and Negative Syndrome Scale (PANSS), subscale for hallucinosis. RESULTS: Valproate-treated patients demonstrated a greater improvement than placebo-treated patients in CGI (P < 0.001) and PANSS subscale for verbal hallucinosis (P < 0.001). CONCLUSION: Valproate is effective in the treatment of acute hallucinosis and is generally well tolerated.

Valproate (depakine-chrono) in the acute treatment of outpatients with generalized anxiety disorder without psychiatric comorbidity: randomized, double-blind placebo-controlled study.

OBJECTIVE: Anxiety disorders are highly prevalent in population of European countries. However, the effect of Valproate (depakine-chrono) on generalized anxiety disorder (GAD) has not been studied in a double-blind placebo-controlled design. METHOD: Eighty patients (all men) were washout from the all medications. Each patient was randomized to receive either depakine-chrono (40 patients) for 6 weeks or matched placebo (40 patients) in a double-blind manner. Eligible participants, in addition to meeting the DSM-IV criteria for GAD and having a minimum score of 25 and more on the Hamilton Anxiety Scale, were required to be between 18 and 65 years. Response was defined as a 50% reduction in the Hamilton anxiety scale score. Response and side effects with depakine-chrono and placebo were compared by using analysis of variance (ANOVA) and chi-square tests. Six patients did not return for at least one subsequent assessment, leaving 74 patients (36 taking depakine-chrono and 38 taking placebo) in the valuables study group. RESULTS: Twenty six of the 36 depakine-chrono-treated participants responded by 6 weeks, versus six of the 38 placebo-treated participants (p<0.001). The most common and problematic side effect in the depakine-chrono group was dizziness and nausea. CONCLUSIONS: The authors believe this to be the first double-blind placebo-controlled randomization study to test the efficacy of a depakine-chrono in the management of anxiety disorders. They need to be replicated in a larger study group.

Application of glycine in acute alcohol hallucinosis.

INTRODUCTION: Previous studies showed that patients with acute alcohol hallucinosis had significantly lower levels of the inhibitory amino acid neurotransmitter, glycine. METHODS: A placebo-controlled, double-blind study of glycine in 40 patients with acute alcohol hallucinosis. Treatment duration was 7 days with no other psychotropic medication. RESULTS: The 20 patients randomised to the active drug (700 mg glycine sublingually) demonstrated a significant decrease in severity of hallucinosis compared to the 20 patients receiving placebo. CONCLUSION: The positive effects of glycine may be related to an altered balance between excitatory and inhibitory amino acid neurotransmitters.