This study will compare triple and double drug regimens in the treatment of patients with
depression, hypomania, or mania.
Early studies have shown lithium to produce a high percentage of satisfactory clinical
response in patients with bipolar disorders. These studies, however, do not include
lithium-refractory subgroups, such as bipolar II disorder patients. When the wide spectrum
of bipolar disorders is considered, the lithium response rate decreases significantly. More
broadly effective regimens are needed.
Participants in this study will be randomly assigned to receive either lithium plus
divalproex or lithium, divalproex, and lamotrigine for 7 months. Symptoms of depression and
mania will be assessed with scales and patient questionnaires.
- Bipolar I or II Disorder
- Meet criteria for rapid cycling, defined as four or more episodes over the past 12
- Meet criteria for a major depressive episode
- History of intolerability of lithium, divalproex, or lamotrigine
Keming Gao, MD, PhD
Case Western Reserve University / University Hospitals of Cleveland