Identification of Treatment-Resistant Depressives Who Respond Favorably to Carbamazepine

Thirteen depressed patients with documented histories of failure to respond to tricyclic antidepressant medications who reported multiple partial seizure like symptoms were given open trials of carbamazepine. Eleven of the 13 showed moderate to substantial improvement in affective status that was accompanied by significant mean changes on the Beck or Hamilton depression scales. In addition, the mean number of reported partial seizure-like symptoms decreased significantly with treatment. Dichotic word listening performance was the only neuropsychological variable that was impaired at baseline and was also the only cognitive performance that improved following treatment. These preliminary observations suggest that there is likely to be a subgroup of treatment-resistant, carbamazepine-responsive depressives who can be identified by evaluating for the presence of multiple partial seizure-like symptoms.