Oxcarbazepine Treatment of Bipolar Disorder
S. Nassir Ghaemi, MD; Douglas A. Berv, MD; Jeffry Klugman, MD; Klara J. Rosenquist, BS; and Douglas J. Hsu, BS
J Clin Psychiatry 2003;64(8):943-945
© Copyright 2019 Physicians Postgraduate Press, Inc.
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Objective: To assess the effectiveness
and safety of oxcarbazepine in bipolar disorder.
Method: A chart review of naturalistic
treatment with oxcarbazepine in 42 outpatients with DSM-IV
bipolar disorder (10 males, 32 females; mean ± SD age = 33.3 ±
12.4 years; 25 with bipolar disorder type I, 4 with bipolar
disorder type II, and 13 with bipolar disorder not otherwise
specified) was conducted. Patients had received oxcarbazepine
monotherapy or adjunctive therapy between April 2000 and April
2002. Treatment response was defined as a Clinical Global
Impressions-Improvement scale score of 1 (marked improvement) or
2 (moderate improvement).
Results: Oxcarbazepine was moderately to
markedly effective in 24 subjects (57%). Mixed symptoms were the
most common indication (52% [22/42]). The mean oxcarbazepine dose
was 1056.6 mg/day, and mean treatment duration was 16.2 weeks.
Sedation (17/42, 40%) was the most common side effect, but 16
patients (38%) had no side effects. Twenty-two patients (52%)
stopped treatment, mostly due to side effects (12/22). Males were
more likely to respond than females (10/10 vs. 14/32, p = .006).
Dose, bipolar subtype, indication, past nonresponse to mood
stabilizers, concurrent mood stabilizer use, and monotherapy use
of oxcarbazepine did not differentially predict response.
Conclusion: Oxcarbazepine appeared
effective in about one half of patients with bipolar disorder and
was well tolerated.