Mood stabilisers

Mood stabiliser medications assessed in this category include lithium, as well as anticonvulsant medications such as valproate, carbamazepine, and lamotrigine.

Carbamazepine

What is carbamazepine? Carbamazepine is an anticonvulsant used primarily in the treatment of seizure disorders such as epilepsy. Anticonvulsant medications influence the actions of neurotransmitters leading to a decrease in brain cell (neuron) excitability. In bipolar disorder, carbamazepine is used mainly for the treatment of mania. What is the evidence for carbamazepine as a treatment for bipolar disorder? Moderate quality evidence suggests medium-sized effects of greater improvement in acute mania symptoms with carbamazepine than with placebo or topiramate, although there was a large effect of greater improvement n acute mania symptoms with tamoxefin than with carbamazepine. There was more discontinuation…

Gabapentin

What is gabapentin? Gabapentin is an anticonvulsant used primarily in the treatment of seizure disorders such as epilepsy. Anticonvulsant medications influence the actions of neurotransmitters leading to a decrease in brain cell (neuron) excitability. What is the evidence for gabapentin as a treatment for bipolar disorder? Moderate to low quality evidence suggests no differences between gabapentin and placebo for the treatment of mania symptoms. Low quality evidence is unable to determine differences between groups for treatment discontinuation; an indication of tolerability. April 2019

Lamotrigine

What is lamotrigine? Lamotrigine is an anticonvulsant used primarily in the treatment of epilepsy. Anticonvulsant medications influence the actions of neurotransmitters leading to a decrease in brain cell (neuron) excitability. In bipolar disorder, lamotrigine is used mainly for the treatment of depression. What is the evidence for lamotrigine as a treatment for bipolar disorder? Compared to placebo, moderate to high quality evidence suggests a small effect of greater improvement in depression symptoms, but not mania symptoms, with mono or adjunctive lamotrigine, and no differences in adverse events, including switching to mania. Compared to other medications, moderate to high quality evidence…

Levetiracetam

We have not found any systematic reviews on this topic that meet the inclusion criteria. Pending enough primary studies, we invite reviews on this topic to be conducted. Alternatively we will endeavour to conduct our own review to fill this gap in the Library. April 2019

Licarbazepine

What is licarbazepine? Licarbazepine is an anticonvulsant used primarily in the treatment of epilepsy. Anticonvulsant medications influence the actions of neurotransmitters leading to a decrease in brain cell (neuron) excitability. What is the evidence for licarbazepine as a treatment for bipolar disorder? Moderate quality evidence suggests licarbazepine is less effective than tamoxefin or risperidone for acute mania symptoms. There may be more discontinuation of treatment with licarbazepine than with olanzapine. There were no significant differences in acute mania symptoms between treatment with licarbazepine and placebo or other medications. April 2019

Lithium

What is lithium? Since the 1960s, lithium has become a mainstay of treatment for bipolar disorders. It has been recommended for both the treatment of acute mania and for the augmentation of antidepressants in depression, although its effectiveness as an antidepressant when used alone has been disputed. What is the evidence for lithium as a treatment for bipolar disorder? Symptoms Moderate to high quality evidence suggests medium-sized effects of greater improvement in acute mania symptoms with lithium than with placebo or topiramate, although there was a large effect of greater improvement in acute mania symptoms with tamoxefin than with lithium….

Oxcarbazepine

What is oxcarbazepine? Oxcarbamazepine is an anticonvulsant used primarily in the treatment of seizure disorders such as epilepsy. Anticonvulsant medications influence the actions of neurotransmitters leading to a decrease in brain cell (neuron) excitability. What is the evidence for oxcarbazepine as a treatment for bipolar disorder? Low quality evidence is unable to determine the benefits or harms of oxcarbamazepine over placebo, valproate, or carbamazepine (as an adjunctive to lithium) for acute bipolar disorder. April 2019

Pregabalin

What is pregabalin? Pregabalin is a medication primarily used to treat epilepsy and neuropathic pain. It has also been tested for people with treatment-resistant bipolar disorder. What is the evidence for pregabalin for treatment-resistant bipolar disorder? Low quality evidence is unable to determine the effects of pregabalin for treatment-resistant bipolar disorder due to a lack of large, randomised trials. April 2019

Tiagabine

We have not found any systematic reviews on this topic that meet the inclusion criteria. Pending enough primary studies, we invite reviews on this topic to be conducted. Alternatively we will endeavour to conduct our own review to fill this gap in the Library. April 2019

Topriamate

What is topriamate? Topriamate is an anticonvulsant medication primarily used to treat epilepsy and migrane headaches. It has also been tested for people with bipolar disorder. What is the evidence for topriamate for bipolar disorder? Moderate quality evidence showed no significant differences in mania or mixed symptoms following treatment with topiramate or placebo for up to 12 weeks. There was greater improvement in mania and mixed symptoms with lithium than with topiramate. There were no differences in side effects between topiramate and placebo or lithium. April 2019

Valproate

What is valproate? Valproate and its derivitive, divalproex, are anticonvulsants used primarily in the treatment of epilepsy and migraine headaches. Anticonvulsant medications influence the actions of neurotransmitters leading to a decrease in brain cell (neuron) excitability. In bipolar disorder, valproate is used mainly for the treatment of mania or mixed symptoms. What is the evidence for valproate as a treatment for bipolar disorder? For symptoms, moderate to low quality evidence suggests a medium-sized effect of greater improvement in acute depression symptoms with valproate than with placebo. Moderate to high quality evidence suggests medium-sized effects of greater improvement in acute mania…

Zonisamide

What is zonisamide? Zonisamide is an anticonvulsant used primarily in the treatment of seizure disorders such as epilepsy. Anticonvulsant medications influence the actions of neurotransmitters leading to a decrease in brain cell (neuron) excitability. In bipolar disorder, zonisamide is used mainly for the treatment of bipolar depression. What is the evidence for zonisamide as a treatment for bipolar disorder? Moderate to low quality evidence suggests zonisamide may be effective for general clinical improvement and depression, however when compared to placebo there were no differences between groups in mania, hypomania or mixed symptoms. April 2019

NeuRA Libraries

Title Colour Legend:
Green - Topic summary is available.
Orange - Topic summary is being compiled.
Red - Topic summary has no current systematic review available.