A placebo-controlled study of lamotrigine and gabapentin monotherapy in refractory mood disorders

Mark A Frye, Terence A. Ketter, Timothy A. Kimbrell, Robert T. Dunn, Andrew M. Speer, Elizabeth A. Osuch, David A. Luckenbaugh, Gabriela Corá-Locatelli, Gabriele S. Leverich, Robert M. Post

Research output: Contribution to journalArticle

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Abstract

There is a pressing need for additional treatment options for refractory mood disorders. This controlled comparative study evaluated the efficacy of lamotrigine (LTG) and gabapentin (GBP) monotherapy versus placebo (PLC). Thirty-one patients with refractory bipolar and unipolar mood disorders participated in a double-blind, randomized, crossover series of three 6-week monotherapy evaluations including LTG, GBP, and PLC. There was a standardized blinded titration to assess clinical efficacy or to determine the maximum tolerated daily dose (LTG 500 mg or GBP 4,800 mg). The primary outcome measure was the Clinical Global Impressions Scale (CGI) for Bipolar Illness as supplemented by other standard rating instruments. The mean doses at week 6 were 274 ± 128 mg for LTG and 3,987 ± 856 mg for GBP. Response rates (CGI ratings of much or very much improved) were the following: LTG, 52% (16/31); GBP, 26% (8/31); and PLC, 23% (7/31) (Cochran's Q = 6.952, df = 2, N = 31, p = 0.031). Post hoc Q differences (df = 1, N = 31) were the following: LTG versus GBP (Q(diff) = 5.33, p = 0.011); LTG versus PLC (Q(diff) = 4.76, p = 0.022); and GBP versus PLC (Q(diff) = 0.08, p = 0.70). With respect to anticonvulsant dose and gender, there was no difference between the responders and the nonresponders. The agents were generally well tolerated. This controlled investigation preliminarily suggests the efficacy of LTG in treatment-refractory affectively ill patients. Further definition of responsive subtypes and the role of these medications in the treatment of mood disorders requires additional study.

Original languageEnglish (US)
Pages (from-to)607-614
Number of pages8
JournalJournal of Clinical Psychopharmacology
Volume20
Issue number6
DOIs
StatePublished - 2000
Externally publishedYes

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Mood Disorders
Placebos
Maximum Tolerated Dose
gabapentin
lamotrigine
Anticonvulsants
Therapeutics
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

A placebo-controlled study of lamotrigine and gabapentin monotherapy in refractory mood disorders. / Frye, Mark A; Ketter, Terence A.; Kimbrell, Timothy A.; Dunn, Robert T.; Speer, Andrew M.; Osuch, Elizabeth A.; Luckenbaugh, David A.; Corá-Locatelli, Gabriela; Leverich, Gabriele S.; Post, Robert M.

In: Journal of Clinical Psychopharmacology, Vol. 20, No. 6, 2000, p. 607-614.

Research output: Contribution to journalArticle

Frye, MA, Ketter, TA, Kimbrell, TA, Dunn, RT, Speer, AM, Osuch, EA, Luckenbaugh, DA, Corá-Locatelli, G, Leverich, GS & Post, RM 2000, 'A placebo-controlled study of lamotrigine and gabapentin monotherapy in refractory mood disorders', Journal of Clinical Psychopharmacology, vol. 20, no. 6, pp. 607-614. https://doi.org/10.1097/00004714-200012000-00004
Frye, Mark A ; Ketter, Terence A. ; Kimbrell, Timothy A. ; Dunn, Robert T. ; Speer, Andrew M. ; Osuch, Elizabeth A. ; Luckenbaugh, David A. ; Corá-Locatelli, Gabriela ; Leverich, Gabriele S. ; Post, Robert M. / A placebo-controlled study of lamotrigine and gabapentin monotherapy in refractory mood disorders. In: Journal of Clinical Psychopharmacology. 2000 ; Vol. 20, No. 6. pp. 607-614.
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AU - Speer, Andrew M.

AU - Osuch, Elizabeth A.

AU - Luckenbaugh, David A.

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AU - Post, Robert M.

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