A randomized, double-blind, placebo-controlled, trial of lamotrigine therapy in bipolar disorder, depressed or mixed phase and cocaine dependence

E. Sherwood Brown, Prabha Sunderajan, Lisa T. Hu, Sharon M. Sowell, Thomas J. Carmody

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Bipolar disorder is associated with very high rates of substance dependence. Cocaine use is particularly common. However, limited data are available on the treatment of this population. A 10-week, randomized, double-blind, placebo-controlled trial of lamotrigine was conducted in 120 outpatients with bipolar disorder, depressed or mixed mood state, and cocaine dependence. Other substance use was not exclusionary. Cocaine use was quantified weekly by urine drug screens and participant report using the timeline follow-back method. Mood was assessed with the Hamilton rating scale for depression, quick inventory of depressive symptomatology self-report, and young mania rating scale. Cocaine craving was assessed with the cocaine-craving questionnaire. Data were analyzed using a random regression analysis that used all available data from participants with at least one postbaseline assessment (n112). Lamotrigine and placebo groups were similar demographically (age 45.1±7.3 vs 43.5±10.0 years, 41.8% vs 38.6% women). Urine drug screens (primary outcome measure) and mood symptoms were not significantly different between groups. However, dollars spent on cocaine showed a significant initial (baseline to week 1, p=0.01) and by-week (weeks 1-10, p=0.05) decrease in dollars spent on cocaine, favoring lamotrigine. Few positive trials of medications for cocaine use, other than stimulant replacement, have been reported, and none have been reported for bipolar disorder. Reduction in amount of cocaine use by self-report with lamotrigine suggests that a standard treatment for bipolar disorder may reduce cocaine use. A study limitation was weekly assessment of urine drug screens that decreased the ability to detect between-group differences.

Original languageEnglish (US)
Pages (from-to)2347-2354
Number of pages8
JournalNeuropsychopharmacology
Volume37
Issue number11
DOIs
StatePublished - Oct 2012

Fingerprint

Cocaine-Related Disorders
Bipolar Disorder
Cocaine
Placebos
Therapeutics
Urine
Self Report
Pharmaceutical Preparations
lamotrigine
Aptitude
Substance-Related Disorders
Outpatients
Regression Analysis
Outcome Assessment (Health Care)
Depression
Equipment and Supplies

Keywords

  • bipolar disorder
  • clinical trial
  • cocaine dependence
  • lamotrigine

ASJC Scopus subject areas

  • Pharmacology
  • Psychiatry and Mental health

Cite this

A randomized, double-blind, placebo-controlled, trial of lamotrigine therapy in bipolar disorder, depressed or mixed phase and cocaine dependence. / Brown, E. Sherwood; Sunderajan, Prabha; Hu, Lisa T.; Sowell, Sharon M.; Carmody, Thomas J.

In: Neuropsychopharmacology, Vol. 37, No. 11, 10.2012, p. 2347-2354.

Research output: Contribution to journalArticle

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