Combination Therapy for the Treatment of Bipolar Disorders

Combination Therapy in Bipolar Rapid Cycling

This study will compare triple and double drug regimens in the treatment of patients with depression, hypomania, or mania.

Early studies have shown lithium to produce a high percentage of satisfactory clinical response in patients with bipolar disorders. These studies, however, do not include lithium-refractory subgroups, such as bipolar II disorder patients. When the wide spectrum of bipolar disorders is considered, the lithium response rate decreases significantly. More broadly effective regimens are needed.

Participants in this study will be randomly assigned to receive either lithium plus divalproex or lithium, divalproex, and lamotrigine for 7 months. Symptoms of depression and mania will be assessed with scales and patient questionnaires.

Inclusion Criteria:

• Bipolar I or II Disorder
• Meet criteria for rapid cycling, defined as four or more episodes over the past 12 months
• Meet criteria for a major depressive episode

Exclusion Criteria:

• History of intolerability of lithium, divalproex, or lamotrigine