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Use of mood stabilizer drugs in the treatment of major depressive dissorder in an outpatient mental health center

Background

Major depressive disorder (MDD) is a common and disabling psychiatric condition. Antidepressants are currently the mainstay of treatment for depression; however, almost two thirds of patients will fail to achieve remission with initial treatment, as a result, a range of augmentation and combination strategies have been used [1].

Materials and methods

Major depressive disorder (MDD) is a common and disabling psychiatric condition. Antidepressants are currently the mainstay of treatment for depression; however, almost two thirds of patients will fail to achieve remission with initial treatment, as a result, a range of augmentation and combination strategies have been used [1].

Results

Mood stabilizers are used in 14% of the sample with a predominancy in the female gender (85.7%), a global average age 50.6 ± 12.2 years. Regarding personal psychiatric background, there's an absence of these in the first place (64.3%), followed by the presence of previous depressive episodes (21.4%) and dysthymic disorder (7.1%). In none of these cases there was toxic abuse. There is a predominancy in the absence of previous psychiatric hospitalisations (64.3%).

The frequencies of use of mood stabilizers was: topiramate in the first place (50%) followed by lithium, carbamazepine and pregabaline (14.28% each of them), in the last place lamotrigine (7.1%). The average dose was 900 mg/d for carbamazepine, 600 mg/d for lithium, 300 mg/d for pregabaline, 128.5 mg/d for topiramate and 100 mg/d for lamotrigine.

Conclusions

In our sample the frequency of use of lithium is similar to the registered for the several antiepiletics (lithium, carbamazepine and pregabaline: 14.28% each one). However, lithium addition is recommended as a first choice for depressed patients who do not respond to therapy with conventional antidepressants [2].

References

  1. 1.

    Craig Nelson J, Pikalov A, Berman R: "Augmentation treatment in major depressive disorder: focus on aripiprazole". Neuropsychiatri Dis Treat San Francisco. 2008, 4 (5): 937-948.

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  2. 2.

    Baver M, Döpfmer S: Lithium augmentation in treatment-resistant depresión: metaanalysis of placebo-controlled studies. J Clin Psychopharmacol. 1 (5): 427-434.

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Correspondence to Carolina Garnier.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Garnier, C., Castaño, J., Alvaro, P. et al. Use of mood stabilizer drugs in the treatment of major depressive dissorder in an outpatient mental health center. Ann Gen Psychiatry 9, S168 (2010). https://doi.org/10.1186/1744-859X-9-S1-S168

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Keywords

  • Lithium
  • Carbamazepine
  • Major Depressive Disorder
  • Lamotrigine
  • Topiramate