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In patients with bipolar depression, antidepressants can induce dysphoric hypomania and ultradian cycling (or multiple affective episodes every few days), and the efficacy of antimanic drugs is questionable. This open study suggests that carbamazepine may have acute antidepressant properties in bipolar patients.
Researchers administered carbamazepine alone or in combination with lorazepam for anxiety to 27 inpatients with bipolar depression and 9 inpatients who met criteria for both mania and major depressive disorder. Doses of carbamazepine were adjusted according to adverse effects to a maximum of 1000 mg/day (serum levels were not reported).
After three weeks, bipolar depressed patients had a mean reduction of 73% in Hamilton Rating Scale …