Lamotrigine therapy in treatment-resistant menstrually-related rapid cycling bipolar disorder: a case report

Bipolar Disorders
O V BeckerT A Ketter

Abstract

To evaluate lamotrigine in a woman with a 30-year history of treatment-resistant menstrually-entrained rapid cycling bipolar II disorder with follicular phase depressive and luteal phase mood elevation symptoms. Lamotrigine was started at 5 mg/day and gradually increased up to 300 mg/day, while venlafaxine was tapered gradually and discontinued, and divalproex sodium 500 mg/day and levothyroxine 175 mcgm/day were continued. Daily self-reported mood ratings were obtained from the patient, using ChronoRecord software. As lamotrigine was increased gradually, mood cycle amplitude attenuated. There was notable decrease in the severity and duration of depressive symptoms specifically during the follicular phase of the menstrual cycle. At the time of submission of this paper, the subject had remained euthymic for a total of 12 months. This case suggests the potential utility of lamotrigine in treatment-resistant menstrually-related rapid cycling bipolar disorder, and raises the possibility that lamotrigine might be able to treat pathological entrainment of mood with the menstrual cycle. Both of these issues merit systematic assessment.

References

Jul 1, 1976·Comprehensive Psychiatry·S B DiamondR R Fieve
Feb 1, 1992·Journal of Clinical Psychopharmacology·J R CalabreseS C Wagner
Feb 1, 1992·Archives of General Psychiatry·W CoryellM Keller
May 1, 1987·Psychiatry Research·R M PostR T Joffe
Nov 1, 1987·The American Journal of Psychiatry·T A Wehr, F K Goodwin
Feb 1, 1988·The American Journal of Psychiatry·T A WehrR W Cowdry
Jan 1, 1982·Acta Psychiatrica Scandinavica·U HalbreichJ Nee
Oct 1, 1993·Journal of Affective Disorders·J Endicott
May 1, 1996·Annals of Neurology·J I IsojärviV V Myllylä
Oct 10, 1998·The American Journal of Psychiatry·L Tondo, R J Baldessarini
Dec 6, 2000·Journal of Clinical Psychopharmacology·M A FryeR M Post
Mar 5, 2002·The Journal of Clinical Psychiatry·Terence A Ketter, Joseph R Calabrese
Mar 27, 2003·Bipolar Disorders·Natalie RasgonPeter C Whybrow
Aug 27, 2003·Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists·Terence A KetterYen-Shou Yang
Oct 2, 2003·Journal of Clinical Psychopharmacology·Terence A KetterRobert M Post

❮ Previous
Next ❯

Citations

Oct 28, 2010·Expert Review of Neurotherapeutics·William V Bobo, Richard C Shelton
Aug 28, 2004·Acta Psychiatrica Scandinavica. Supplementum·T A KetterW K Marsh
Feb 17, 2006·Perspectives in Psychiatric Care·Deborah Antai-Otong
Jan 29, 2014·Bipolar Disorders·Missy L TeateroVerinder Sharma
Mar 9, 2010·American Journal of Obstetrics and Gynecology·Joann V PinkertonHugh S Taylor
Nov 9, 2010·Journal of Clinical Psychopharmacology·Ravi Chand Sharma
Apr 14, 2006·Expert Opinion on Drug Safety·Howard H FennBrian Alldredge

❮ Previous
Next ❯

Related Concepts

Related Feeds

Bipolar Disorder

Bipolar disorder is characterized by manic and/or depressive episodes and associated with uncommon shifts in mood, activity levels, and energy. Discover the latest research this illness here.