OBJECTIVE: To compare the efficacy and tolerability of tranylcypromine vs. lamotrigine in bipolar depression not responding to conventional antidepressants. METHOD:Bipolar depressed patients received open randomized treatment with tranylcypromine or lamotrigine as add-on to a mood stabilizer during 10 weeks. In a second treatment phase, non-responding patients could receive the opposite drug. Outcome criteria were response (measured with CGI-BP and IDS-C), switch into mania, and completion of the study. RESULTS: Only 20 of 70 planned patients were randomized, due to problems with recruitment, and 19 patients received any medication. During the first treatment phase 5/8 patients (62.5%) responded to tranylcypromine without switch into mania, compared with 4/11 patients (36.4%) on lamotrigine with two switches (statistically not significant). Over both treatment phases, 8/10 patients (80%) receiving tranylcypromine completed the study vs. 5/13 (38.5%) on lamotrigine (likelihood 0.02). CONCLUSION: There still appears to be a role for tranylcypromine in the treatment of refractory bipolar depression. Larger controlled studies are demanded.
RCT Entities:
OBJECTIVE: To compare the efficacy and tolerability of tranylcypromine vs. lamotrigine in bipolar depression not responding to conventional antidepressants. METHOD:Bipolar depressedpatients received open randomized treatment with tranylcypromine or lamotrigine as add-on to a mood stabilizer during 10 weeks. In a second treatment phase, non-responding patients could receive the opposite drug. Outcome criteria were response (measured with CGI-BP and IDS-C), switch into mania, and completion of the study. RESULTS: Only 20 of 70 planned patients were randomized, due to problems with recruitment, and 19 patients received any medication. During the first treatment phase 5/8 patients (62.5%) responded to tranylcypromine without switch into mania, compared with 4/11 patients (36.4%) on lamotrigine with two switches (statistically not significant). Over both treatment phases, 8/10 patients (80%) receiving tranylcypromine completed the study vs. 5/13 (38.5%) on lamotrigine (likelihood 0.02). CONCLUSION: There still appears to be a role for tranylcypromine in the treatment of refractory bipolar depression. Larger controlled studies are demanded.
Authors: Alan G Mallinger; Ellen Frank; Michael E Thase; Michelle M Barwell; Nancy Diazgranados; David A Luckenbaugh; David J Kupfer Journal: Psychopharmacol Bull Date: 2009
Authors: Isabella Pacchiarotti; David J Bond; Ross J Baldessarini; Willem A Nolen; Heinz Grunze; Rasmus W Licht; Robert M Post; Michael Berk; Guy M Goodwin; Gary S Sachs; Leonardo Tondo; Robert L Findling; Eric A Youngstrom; Mauricio Tohen; Juan Undurraga; Ana González-Pinto; Joseph F Goldberg; Ayşegül Yildiz; Lori L Altshuler; Joseph R Calabrese; Philip B Mitchell; Michael E Thase; Athanasios Koukopoulos; Francesc Colom; Mark A Frye; Gin S Malhi; Konstantinos N Fountoulakis; Gustavo Vázquez; Roy H Perlis; Terence A Ketter; Frederick Cassidy; Hagop Akiskal; Jean-Michel Azorin; Marc Valentí; Diego Hidalgo Mazzei; Beny Lafer; Tadafumi Kato; Lorenzo Mazzarini; Anabel Martínez-Aran; Gordon Parker; Daniel Souery; Ayşegül Ozerdem; Susan L McElroy; Paolo Girardi; Michael Bauer; Lakshmi N Yatham; Carlos A Zarate; Andrew A Nierenberg; Boris Birmaher; Shigenobu Kanba; Rif S El-Mallakh; Alessandro Serretti; Zoltan Rihmer; Allan H Young; Georgios D Kotzalidis; Glenda M MacQueen; Charles L Bowden; S Nassir Ghaemi; Carlos Lopez-Jaramillo; Janusz Rybakowski; Kyooseob Ha; Giulio Perugi; Siegfried Kasper; Jay D Amsterdam; Robert M Hirschfeld; Flávio Kapczinski; Eduard Vieta Journal: Am J Psychiatry Date: 2013-11 Impact factor: 18.112