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Evidence summaries

Oxcarbazepine in the Maintenance Treatment of Bipolar Disorder

There is insufficient evidence from randomised controlled trials regarding the use of oxcarbazepine in maintenance phase of bipolar illness, either in monotherapy or as an adjunctive treatment. Level of evidence: "D"

A Cochrane review [Abstract] 1 included 2 studies with a total of 34 subjects. The participants were randomised to either oxcarbazepine (n=12) or lithium (n=13). Four participants were included separately in a non-random group and were offered oxcarbazepine, and five other participants were treated with oxcarbazepine after unsatisfactory treatment or if they had severe side-effects with lithium. In the other study, a thirty six month follow up was planned, but all patients dropped out prior to that. The other study reported high discontinuation rates in participants on oxcarbazepine (67%) and lower rates for patients on lithium (33%). No further conclusions could be drawn on the basis of these two poor-quality studies.

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment, more than 20% loss to follow up) and by imprecise results (few patients and wide confidence intervals).

References

  • Vasudev A, Macritchie K, Watson S, Geddes JR, Young AH. Oxcarbazepine in the maintenance treatment of bipolar disorder. Cochrane Database Syst Rev 2008 Jan 23;(1):CD005171. [PubMed]

Primary/Secondary Keywords