Article Summaries x2

Article #1: “A Double-Blind, Randomized, Placebo-Controlled Trial of Oxcarbazepine in the

Treatment of Bipolar Disorder in Children and Adolescents”

This article is a segment of The American Journal of Psychiatry, published July 1, 2006.

There are many authors on this piece, such as; Karen Dineen Wagner, M.D.,Ph.D., who is a

Professor in Department of Psychiatry and Behavioral Sciences and Director of the Division of

Child and Adolescent Psychiatry at University of Texas Medical Branch in Galveston. Next you

have Robert A. Kowatch, M.D. who is a Professor of Psychiatry in the Center for Innovation in

Pediatric Practice at the Research Institute at Nationwide Children's Hospital. Timothy E.

Wilens, M.D. is Chief, Division of Child and Adolescent Psychiatry, Co-Director, Center for

Addiction Medicine, and Director, Substance Abuse Services in Pediatric Psychopharmacology

at MassGeneral Hospital for Children. Robert E. Lehman, M.D. expertise is in the area of

diagnosis and psychopharmacology. Douglas Berv, M.D. is a psychiatrist in Hamden,

Connecticut and is affiliated with Yale-New Haven Hospital. He received his medical degree

from Yale University School of Medicine and has been in practice for more than 20 years. David

Linden, M.D. is a Professor of neuroscience at Johns Hopkins School of Medicine.

This research was to examine the efficacy and safety of oxcarbazepine in the treatment of

bipolar disorder in children and adolescents. A total of 116 outpatients 7 to 18 years of age with

bipolar I disorder, manic or mixed, were recruited at 20 centers in the United States and

randomly assigned to receive 7 weeks of double-blinded, flexibly dosed treatment with

oxcarbazepine (maximum dose 900–2400 mg/day) or placebo. Oxcarbazepine did not

significantly improve YMRS scores at endpoint compared with placebo. Dizziness, nausea,

somnolence, diplopia, fatigue, and rash were each reported in at least 5% of the patients in the

oxcarbazepine group with an incidence at least twice that of the placebo group. The majority of

adverse events were mild to moderate and occurred during the titration period. Eleven patients

(19%) in the oxcarbazepine group discontinued the study because of adverse events, compared

with two (4%) in the placebo group. In conclusion, Oxcarbazepine was found to not be more

helpful compared to placebo drugs in the treatment of bipolar disorder in youths. While the

overall adverse event profile was similar to that reported for patients with epilepsy, the incidence

of negative psychiatric for both the oxcarbazepine and placebo groups was higher than that

reported for the epilepsy population. I believe the purpose of this study was to inform the reader

of recent research and to publicly introduce the research.

This topic is important to psychology because it pertains to the treatment of a

psychological disorder. The article gave more than enough information on the topic at hand, but I

feel that the study would have benefited from having more than 116 participants. I agree with the

results, because after reading over the study it made sense to how they got it. I believe the article

is a trustworthy source because the American Journal of Psychiatry is a respected, peer-reviewed

journal that has been published for years, and the authors are professionals in the field.

My two questions would be:

1. Why did the researchers not compare two different medications that help with bipolar

disorders?

2. Could the use of different dosages of the same medication be studied in the two

groups?

References

Wagner, K. D., Kowatch, R. A., Wilens, T. E., Lehman, R.E., Bery, D., and Linden, D. (2006).

A Double-Blind, Randomized, Placebo-Controlled Trial of Oxcarbazepine in the

Treatment of Bipolar Disorder in Children and Adolescents. American Journal of

Psychiatry, 163(7), 1179-1186. doi:10.1176/ajp.2006.163.7.1179