title: Clinical factors leading to lamotrigine prescription in bipolar outpatients: subanalysis of the SIN-DEPRES study.
abstract: BACKGROUND
  The use of lamotrigine is a point of discrepancy among the diverse guidelines published on the management of bipolar disorder (BD). Evidence supporting the long-term efficacy is reasonably robust. Nonetheless, the effectiveness of lamotrigine in acute treatment is vigorously debated and it is unclear how this drug is used in routine clinical practice. This subanalysis of the SIN-DEPRES study was designed to understand the clinical profile of bipolar patients receiving lamotrigine.
  
  
  METHODS
  In this prospective national multicenter study, 652 patients with clinically stable bipolar I and II disorder were recruited. Clinical assessments included sociodemographic and clinical data, the Modified Clinical Global Impression scale for BD (CGI-BP-M), the Hamilton Depression Rating Scale (HDRS), and prescriptions of psychotropic medications and their doses.
  
  
  RESULTS
  By means of a logistic regression model, an association between receiving treatment with lamotrigine and the following clinical variables was found: number of past depressive episodes (O.R.=2.875, 95% CI: 1.203-6.869, p=0.018), depressive polarity of the most recent episode (O.R.=1.945, 95% CI: 1.267-2.985, p=0.002), severity in CGI-BD-M depression (O.R.=1.850, 95% CI: 1.215-2.817, p=0.004), bipolar II disorder diagnosis (O.R.=1.635, 95% CI: 1.078-2.482, p=0.021) and number of episodes per year (O.R.=1.310, 95% CI: 1.069-1.605, p=0.009).
  
  
  CONCLUSIONS
  Subanalysis of the SIN-DEPRES study with a cross-sectional design.
  
  
  CONCLUSIONS
  The use of lamotrigine in clinical practice is in accordance with most of the guidelines, which support its use in patients with depressive predominant polarity and bipolar II disorder.
authors: Bipolar Disorder Program, Clinical Institute of Neuroscience, Hospital Clínic, IDIBAPS, University of Barcelona, CIBERSAM, Villarroel, 170, Barcelona 08036, Spain.
authors: I
authors: I
authors: Grande
authors: V
authors: V
authors: Balanzá-Martínez
authors: Ma
authors: M
authors: Jiménez-Arriero
authors: F G
authors: FG
authors: Iglesias Lorenzo
authors: J I
authors: JI
authors: Franch Valverde
authors: R
authors: R
authors: de Arce
authors: S
authors: S
authors: Zaragoza
authors: S
authors: S
authors: Cobaleda
authors: E
authors: E
authors: Vieta
mesh_terms: D000328:Adult; D000368:Aged; D018692:Antimanic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000523:psychology; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D014227:Triazines / Q000627:therapeutic use*
chemical_list: D018692:Antimanic Agents; D014227:Triazines; D000077213:Lamotrigine