Comparison of carbamazepine and lithium in treatment of bipolar disorder: A systematic review of randomized controlled trials

  title={Comparison of carbamazepine and lithium in treatment of bipolar disorder: A systematic review of randomized controlled trials},
  author={Daniela Ceron-Litvoc and Bernardo Garcia Soares and J. G. Geddes and J{\'u}lio Litvoc and Maur{\'i}cio Silva de Lima},
  journal={Human Psychopharmacology: Clinical and Experimental},
To review data from randomized controlled trials (RCTs) assessing the comparative efficacy of carbamazepine and lithium in treatment of acute manic and maintenance phase of bipolar disorder (BD). 

[Lithium and anticonvulsants in bipolar depression].

The Role of Antiepileptic Drugs in Bipolar Depression

Bipolar depression, underdiagnosed in relation to un bipolar depression, affects both the individual’s affective as well as cognitive areas and is more frequent than hypomania/mania.

[Therapeutic and pharmacologic differences between medications used in the treatment of bipolar disorders: seven-year update].

  • J. Tamayo
  • Psychology, Medicine
    Actas espanolas de psiquiatria
  • 2011
A detailed review was published in 2004 on the therapeutic properties of the medications used in the treatment of bipolar disorders and a new classification that includes: antimanic medications, partial mood stabilizers, and euthymics was proposed.

Mood-Stabilizing Agents

Mood-stabilizing treatments include a variety of types of medicinal agents with important applications in the treatment of bipolar (manic-depressive) disorder patients. Recent estimates indicate that

Antiepileptic drugs in Australia: 2002–2007

The trends in the prescribing of subsidised AEDs in the Australian population from 2002 to 2007 were examined to examine the patterns of prescribing for patients with epilepsy.

Chapter 3 - Lithium

Outcome of Mood Stabilizer Discontinuation in Bipolar Disorder After 5 Years of Euthymia

Patients diagnosed with bipolar affective disorder, receiving mood stabilizer prophylaxis for at least 5 years, had undergone planned discontinuation, and the rates and time to recurrence were studied.

Bipolar disorder.

  • P. Mitchell
  • Psychology, Medicine
    Australian family physician
  • 2013
Clinicians are updated on the recognition, diagnosis and management of bipolar disorder in light of recent research to update clinicians on the strongest evidence base for lithium and atypical antipsychotics.

Bipolar Depression: Overview and Commentary

Emerging treatments, including several anticonvulsant and modern antipsychotic drugs, as well as lithium—alone or in selected combinations—are partially effective for bipolar depression.

Relationships between pharmacokinetic parameters of carbamazepine and therapeutic response in patients with bipolar disease.

It is suggested that both plasma carbamazepine and 10,11-epoxide-carbamazepines levels must be fixed to achieve optimum therapeutic response in patients with bipolar disease and inhibitor drugs or inductor drugs of epoxyde-hydrolase might be coadministered with the carbamazepsine in order to adapt the plasma level.



Lithium versus carbamazepine in the maintenance treatment of bipolar II disorder and bipolar disorder not otherwise specified.

No significant differences between the drugs were found considering hospitalization, recurrences, subclinical recurrence, concomitant medication and severe side-effects during the observation period of 2.5 years.

The comparative prophylactic efficacy of lithium and carbamazepine in patients with bipolar I disorder.

Analyses in patients without psychotropic comedication indicate that the superiority of lithium is not the result of carbamazepine reducing plasma levels of concomitant drugs.


Although statistically non-significant, the trends suggest that use of carbamazepine hastens recovery and leads to less frequent use of emergency sedation without any increase in side effects.

The Effect of Carbamazepine and Lithium on Remission from Affective Illness

Times in remission from affective illness were prolonged during treatment with lithium carbonate and carbamazepine, but lithium was the more effective. Similar global scores for the two drugs

Effectiveness of mood stabilizers and antipsychotics in the maintenance phase of bipolar disorder: a systematic review of randomized controlled trials.

Mood stabilizers have differing profiles of efficacy and tolerability, suggesting complementary roles in long-term maintenance treatment, according to systematic review of randomized controlled trials.

Anticonvulsants in Bipolar Disorder

  • C. BowdenN. Karren
  • Psychology, Medicine
    The Australian and New Zealand journal of psychiatry
  • 2006
Valproate, lamotrigine and carbamazepine have a valuable place in the management of bipolar disorder and in the largest randomised maintenance trial there was only a trend favouring valproate.

Comparison of Carbamazepine and Lithium in the Prophylaxis of Bipolar Disorders

The prophylactic efficacy of carbamazepine remains questionable and differences in statistical power and sensitivity of outcome measure explain this heterogeneity and the conflicting results of the studies.

The comparative efficacy and safety of carbamazepine versus lithium: a randomized, double-blind 3-year trial in 83 patients.

Both drugs were effective in two thirds of the patients and appeared about equal in most outcome measures, except for a significantly higher dropout rate for patients with mood-incongruent psychotic features who were assigned to the lithium group.

A preliminary double-blind study on the efficacy of carbamazepine in prophylaxis of manic-depressive illness

A preliminary double-blind controlled study on the prophylactic effect of carbamazepine on recurrent manic-depressive psychotics was conducted with 22 patients using an inert placebo in ten subjects as a control drug, and it is suggested that carbamazepsine is a useful drug for theProphylaxis of manic- Depressive illness.

Lithium versus carbamazepine in the maintenance treatment of bipolar disorders--a randomised study.