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The Addition of Lithium to CarbamazepineAntidepressant Efficacy in Treatment-Resistant Depression
Keith G. Kramlinger, MD;
Robert M. Post, MD
Arch Gen Psychiatry. 1989;46(9):794-800.
Abstract
• The addition of lithium carbonate to various antidepressant agents, including heterocyclics and monoamine oxidase inhibitors, has been reported to rapidly effect an antidepressant response in otherwise treatment-unresponsive depressed patients. Fifteen depressed patients diagnosed by DSM-III criteria who had not responded to double-blind treatment with crabamazepine were treated with the blind addition of lithium to carbamazepine. Eight patients (53%) responded with a moderate to marked improvement. The time to onset of substantial clinical improvement was rapid; ie, the mean ( ± SD) was 4.1 ± 2.4 days for lithium potentiation compared with 9.7 ±4.1 days in a separate group of depressed patients responding to lithium alone. Side effects during carbamazepine-lithium combination therapy were minimal. The mechanisms by which lithium appears to rapidly potentiate the effects of carbamazepine in treatment-resistant depression are discussed.
Author Affiliations
From the Biological Psychiatry Branch, National Institute of Mental Health, Bethesda, Md.
Footnotes
Accepted for publication February 17, 1989.
Reprint requests to Biological Psychiatry Branch, National Institute of Mental Health, Bldg 10, Room 3N212, 9000 Rockville Pike, Bethesda, MD 20892 (Dr Post).
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