Carbamazepine in the prophylaxis of major depression: a 5-year follow-up
Stuppaeck, C.H.; Barnas, C.; Schwitzer, J.; Fleischhacker, W.W.
Journal of Clinical Psychiatry 55(4): 146-150
1994
ISSN/ISBN: 0160-6689 PMID: 8071258 Document Number: 435007
Background: The prophylaxis of unipolar depression is still controversial. Some physicians prefer lithium, others maintenance treatment with antidepressants. The role of carbamazepine remains unclear. Only a few patients have been described in the literature; most are lithium nonresponders or rapid cyclers. Method: In an open-label naturalistic study, 15 patients suffering from major depression with melancholia (DSM-III, 296.2, 296.3) and receiving long-term prophylaxis with carbamazepine were followed for 5 years. Four had been pretreated with lithium without satisfactory effects, 11 were prophylaxis naive. We compared the number of depressive episodes before and during carbamazepine treatment. Results: The mean time span patients received carbamazepine was 49.5 months. Seventy-three percent (11 of 15) of the patients gained substantial benefit from carbamazepine. Side effects were infrequent. Conclusion: Our results encourage further controlled and prospective studies using carbamazepine for maintenance treatment of patients with unipolar major mood disorder.