Acute antimanic efficacy and safety of oxcarbazepine in an open trial with an on-off-on design

Barbara Hummel, Joerg Walden, Robert Stampfer, Sandra Dittmann, Benedikt Amann, Andrea Sterr, Martin Schaefer, Mark A. Frye, Heinz Grunze

Research output: Contribution to journalArticlepeer-review

54 Scopus citations

Abstract

Rationale and Objectives: Carbamazepine has shown reasonable antimanic properties, but its use has been limited because of enzyme-inducing effects. The keto-derivative oxcarbazepine (OXC) is very similar to carbamazepine, however, the metabolic pathway is different. OXC is not metabolized to the 10, 11-epoxide, which seems to be responsible for several undesirable side-effects of carbamazepine and furthermore OXC has less enzyme-inducing properties. Methods: In this non-random open label study, patients were treated with OXC for 14 days, crossed over to no OXC for 7 days, and then crossed back over to OXC for the remaining 14 days. OXC was titrated to a final dose in a range of 900-2100 mg due to individual response. Treatment success was defined as a reduction of the original Young Mania Rating Scale (YMRS) score of more than 50% at the end of study period. Results: Four of the 12 included patients (33%) met defined response criteria at the end of study period. Fifty percentage of the patients had to be prematurely excluded from the trial. The mean YMRS scores of the on-periods were obviously different from the off-period. Forty-two percentage of the patients experienced side-effects leading to premature discontinuation in two of 12 patients. Conclusion: Antimanic activity of OXC was demonstrated in this pilot study only for patients with mild or moderate manic symptoms. Further studies are encouraged to clarify OXC's role as mood-stabilizer and assess whether it has a profile similar to that of carbamazepine.

Original languageEnglish (US)
Pages (from-to)412-417
Number of pages6
JournalBipolar disorders
Volume4
Issue number6
DOIs
StatePublished - Dec 1 2002

Keywords

  • Anticonvulsants
  • Bipolar disorder mania
  • Oxcarbazepine

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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