title: Adjunctive lamotrigine therapy for patients with bipolar II depression partially responsive to mood stabilizers.
abstract: This naturalistic study explored long-term effectiveness of adjunctive lamotrigine therapy for bipolar II depression. We analyzed prospective data from 109 lamotrigine-treated outpatients with bipolar II depression inadequately responsive to mood stabilizers. Lamotrigine was added to prior treatment in a naturalistic fashion. Changes in depression severity were prospectively monitored for up to 52 weeks using a prospective mood chart and the Clinical Global Impressions-Bipolar Version-Severity (CGI-BP-S). Time to lamotrigine discontinuation during 52-week period was calculated using the Kaplan-Meier estimate. A significant reduction in the CGI-BP-S depression score was observed between baseline and week 52 with a large effect size. The discontinuation rates were 44.0% and 50.5% for the total sample and 14.3% and 22.9% for responders at 24 weeks and 52 weeks, respectively. A higher number of prior hospitalizations for depression and a history of attempted suicide were associated with poor response to adjunctive lamotrigine treatment. Sustained benefits of an open-label lamotrigine add-on were indicated in patients with bipolar II depression. Adjunctive usage of lamotrigine was safe and generally well-tolerated. The potential benefit of adjunctive lamotrigine treatment was suggested in patients with bipolar II disorder suffering from depressive symptoms. Large-scale controlled studies are needed to confirm the effectiveness of adjunctive lamotrigine therapy for bipolar II depression.
authors.affiliation: Department of Neuropsychiatry, Seoul National University Bundang Hospital, 166 Gumi-Ro, Bundang-Gu, Seongnam-Si, Gyeonggi-Do 463-707, Republic of Korea.
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Chang
authors.forename: Eunsoo
authors.initials: E
authors.lastname: Moon
authors.forename: Boseok
authors.initials: B
authors.lastname: Cha
authors.forename: Kyooseob
authors.initials: K
authors.lastname: Ha
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000927:Anticonvulsants / Q000627:therapeutic use*; D018692:Antimanic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D000077213:Lamotrigine; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D014227:Triazines / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D018692:Antimanic Agents; D014227:Triazines; D000077213:Lamotrigine