Bipolar disorders, characterized by alternating manic and depressive episodes, are a common form of mood illnesses. Carbamazepine is a representative anticonvulsant mood stabilizer that has been widely used for treating bipolar disorders since1980s, and compared to other mood stabilizers, its interactions with other agents including herbal preparations have been relatively well-studied.
The famous Traditional Chinese Medicine Formula - Jia Wei Xiao Yao Wan (also known as Chia-Wei-Hsiao-Yao-San) - is traditionally indicated for the treatment of stagnation of liver-qi, deficiency of blood, and disharmony between the liver and spleen. It is widely used by TCM doctors to treat symptoms such as PMS, depression, irregular menstrual cycle, insomnia, and anorexia.
A double-blind, randomized, placebo-controlled clinical study was conducted to evaluate the efficacy and side effects of Jia Wei Xiao Yao San (JWXYS) as an adjunctive to carbamazepine (CBZ) in patients with bipolar disorders. 124 bipolar depressed patients were randomized to treatment with 1) CBZ alone, 2) CBZ plus JWXYS, or 3) equivalent placebo for 12 weeks.
The efficacy measures included the Hamilton Rating Scale for Depression, Montgomery-Asberg Depression Rating Scale, and Clinical Global Impression-Severity (CGI-S).
The results showed that adjunctive JWXYS with CBZ, compared to CBZ monotherapy, yielded significantly better outcomes on the three measures of depression, and significantly greater clinical response rate in depressed subjects (84.8% vs. 63.8%, p=0.032). On top of the positive results, the adjunctive JWXYS added some beneficial effects in bipolar patients, particularly those in depressive phase, for there was lesser incidence of dizziness and fatigue in the combined therapy compared to CBZ monotherapy.
Reference:
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Zhang ZJ, Kang WH, Tan QR, Li Q, Gao CG, Zhang FG, Wang HH, Ma XC, Chen C, Wang W, Guo L, Zhang YH, Yang XB, Yang GD. Adjunctive herbal medicine with carbamazepine for bipolar disorders: A double-blind, randomized, placebo-controlled study. J Psychiatric Research (2007). 41: 360-369.
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