Lamotrigine Use in Geriatric Patients with Bipolar Depression
Bibliographic record
Abstract
OBJECTIVE: To study the effectiveness of adding lamotrigine to the treatment of inpatient geriatric patients with bipolar disorder (BD) who were in the depressed phase and had been on lithium and valproate for at least 3 months. METHOD: Lamotrigine was started at 25 mg given at bedtime, with weekly incremental increases of 12.5 mg daily until a total dosage of either 75 mg or 100 mg was obtained. Improvement was measured by clinical interview and Hamilton Depression Rating Scale (HDRS) scores. Patients were reassessed at 6 weeks, and if their HDRS score had decreased by at least 50%, they were considered to have improved. RESULTS: The study group comprised 5 women with an average age of 71.5 years (range 65 to 85). Four had rapid-cycling BD, and 1 had mixed BD. All patients had early age of onset, as judged by their first contact with a psychiatrist or their first hospitalization. The average initial HDRS score was 27 (range 20 to 35). Of the patients, 3 out of the 5 had remission of symptoms, as judged by clinical interview and reduction of their HDRS score by 50%. At 3 months follow-up, these 3 patients had not required rehospitalization and were doing well. Lamotrigine was well tolerated, and none of the patients developed a rash. One patient did develop coarse hand tremor that improved when the lamotrigine dosage was decreased. CONCLUSIONS: Lamotrigine in conjunction with lithium and valproate may be effective in treating geriatric patients with BD and depression.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".