Kan Lamotrigin utgöra ett Behandlingsalternativ vid Bipolär Sjukdom?

Sammanfattning: Bipolar disorder is a severe, affective illness which causes a person to alternate between episodes of pathologically elevated mood (mania) and depression – in between these episodes the mood is normal. The length and intervals between the episodes are highly variable among the ill, as are the severity which is divided into two major subgroups: bipolar I and II. Bipolar I disorder is the most severe because of the patient’s inability to realize that he or she is currently in a manic phase, in the case of bipolar II disorder, the patient is aware that he or she has an abnormally raised mood, a state which is called hypomanic state instead of manic. The cause of bipolar disorder is yet to be discovered, although both genetic and environmental aspects probably weigh in. Bipolar disorder is treated with a combination of psychotherapy and pharmacology, the most common and oldest treatment regimen being that of lithium, an alkali metal which has been used as a mood stabilizer for over a century. Although being proven effective, lithium can cause thyroid malfunction and has a complicated renal elimination process that can be affected by diet and heritage. This makes regular blood testing for determining concentration of lithium necessary. Lithium can also be toxic in relatively low doses. Lamotrigine is an anticonvulsive drug used for treating epilepsy, but has been proven to also have mood stabilizing properties. To find out if lamotrigine can be used as a treatment for bipolar disorder, both as maintenance treatment as well as acute treatment in manic/hypomanic/depressive episodes, papers from clinical trials where lamotrigine has been tested with lithium and/or placebo have been read. The results show that lamotrigine is as effective as lithium in maintenance and acute treatment of depression, although some papers show conflicting results on the effectiveness compared to placebo. The conclusion is that lamotrigine seems to be a promising drug that can be helpful in the treatment of bipolar disorder.