To Study Effectiveness of Cariprazine Vs Lamotrigine on Cognition in Patients with Bipolar Depression-II

Abstract

Background: Cognitive dysfunction is a major contributor to functional disability in patients with Bipolar Depression Type II and often persists despite improvement in mood symptoms. Cariprazine, a dopamine D3/D2 receptor partial agonist, has demonstrated potential procognitive effects, whereas Lamotrigine is a well-established mood stabilizer for bipolar depression. The present study compared the effectiveness of Cariprazine and Lamotrigine on cognitive function and depressive symptoms in patients with Bipolar Depression Type II. Methods: A prospective, hospital-based comparative follow-up study was conducted among 30 patients diagnosed with Bipolar Depression Type II according to ICD-10 criteria. Participants were equally allocated to receive Cariprazine (n = 15) or Lamotrigine (n = 15) and were followed for 12 weeks. Clinical outcomes were assessed using the Koukopoulos Mixed Depression Rating Scale (KMDRS), Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA), Montreal Cognitive Assessment (MoCA), and UKU Side Effect Rating Scale. Results: Baseline demographic and clinical characteristics were comparable between groups. Both treatments significantly improved depressive symptoms and cognitive performance over the study period. However, Cariprazine demonstrated greater reductions in KMDRS scores (31.8 ± 3.6 to 9.6 ± 2.4) and COBRA scores (23.9 ± 3.5 to 10.8 ± 2.3) than Lamotrigine (32.4 ± 3.4 to 14.8 ± 2.9 and 24.4 ± 3.3 to 15.9 ± 2.7, respectively). Similarly, MoCA scores improved more markedly in the Cariprazine group (21.3 ± 2.5 to 27.6 ± 1.8) than in the Lamotrigine group (20.9 ± 2.6 to 24.8 ± 2.0). Both medications exhibited favorable safety profiles with only mild adverse effects. Conclusion: Both Cariprazine and Lamotrigine effectively improved depressive symptoms and cognition in Bipolar Depression Type II. Nevertheless, Cariprazine demonstrated superior efficacy in enhancing cognitive function and reducing depressive symptom severity while maintaining good tolerability, suggesting its potential as a preferred therapeutic option for cognitive dysfunction in Bipolar Depression Type II. Keywords: Bipolar Depression Type II; Cariprazine; Lamotrigine; Cognitive Dysfunction; Montreal Cognitive Assessment (MoCA).