Adjunctive lamotrigine therapy for patients with bipolar II depression partially responsive to mood stabilizers.
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.
Chang
Jae Seung
JS
Department of Neuropsychiatry, Seoul National University Bundang Hospital, 166 Gumi-Ro, Bundang-Gu, Seongnam-Si, Gyeonggi-Do 463-707, Republic of Korea.
Moon
Eunsoo
E
Cha
Boseok
B
Ha
Kyooseob
K
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
D000927:Anticonvulsants; D018692:Antimanic Agents; D014227:Triazines; D000077213:Lamotrigine