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

ObjectivesWe report the results of a retrospective, naturalistic study of lamotrigine in the management of treatment-resistant bipolar II depression.MethodsHospital 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.ResultsPatients 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.ConclusionsThese 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.LimitationsRetrospective design, small sample size, and lack of a control group.