Source: Atherosclerosis  |  Posted 9 years ago

A pilot study suggests carbamazepine augmentation of citalopram therapy could be clinically useful in depressive patients who do not respond to citalopram alone.

Adding carbamazepine can also lead to decreased plasma concentrations of the active enantiomer, escitalopram, according to European researchers who conducted an open study with four outpatients and two inpatients diagnosed with a major depressive episode.

Participants were non-responders to four weeks pre-treatment therapy with citalopram.

Some of the participants had comorbidities. Two patients had phobic anxiety disorder with panic attacks. Others comorbidities noted were generalised anxiety disorder, alcohol abuse, dependent personality disorder and hypertension.

The investigators added carbamazepine during a second four-week drug therapy period.

They report a slight but significant decrease in patient depression scores within one week of adding carbamazepine. Treatment was generally well tolerated. Adverse events included nausea in one patient, diarrhoea in one patient and rash in two.

The researchers found a significant decrease in plasma concentrations of the citalopram eutomer S-citalopram (27 percent) and in R-citalopram (31 percent). They also observed a significant decrease in the ratio S/R-citalopram propionic acid derivative.