title: Systematic review of lamotrigine augmentation of treatment resistant unipolar depression (TRD).
abstract: OBJECTIVE
  Our aim was to review all the evidence of lamotrigine's effectiveness in treatment resistant depression after at least one failed antidepressant trial.
  
  
  METHODS
  We used a systematic search strategy to identify studies that included adults aged 18-65 years with a diagnosis of unipolar depression who had not responded to at least a 4-week course of a recommended dose of an antidepressant.
  
  
  RESULTS
  We found only one randomized, double blind study that has been published, showing its effectiveness for treatment-resistant depression. In this study, lamotrigine was found statistically superior to placebo on the CGI scale for severity and improvement; however, it was not on the HAM-D (primary end point) and MADRS scales. There were a number of smaller non RCT's which are included.
  
  
  CONCLUSIONS
  There is little evidence to guide the use of lamotrigine for depression that has not responded to a course of antidepressants. Treatment-refractory depression continues to be significant mental health problem and large RCT trials are needed to inform clinical practice.
authors.affiliation: St. Michaels Hospital, Warwick, UK.
authors.forename: Shibu P
authors.initials: SP
authors.lastname: Thomas
authors.forename: Harpal Singh
authors.initials: HS
authors.lastname: Nandhra
authors.forename: Anand
authors.initials: A
authors.lastname: Jayaraman
mesh_terms: D000293:Adolescent; D000328:Adult; D018692:Antimanic Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D004351:Drug Resistance; D004357:Drug Synergism; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D011795:Surveys and Questionnaires; D014227:Triazines / Q000494:pharmacology* / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D018692:Antimanic Agents; D014227:Triazines; D000077213:Lamotrigine