Lamotrigine vs. lamotrigine plus divalproex in randomized, placebo-controlled maintenance treatment for bipolar depression
Acta Psychiatrica Scandinavica, 06/19/2012
Bowden CL et al. – Lamotrigine + divalproex generally provided greater maintenance efficacy than Lam alone for depressive indices in recently depressed bipolar depression patients.Methods
- The authors randomized 86 BD I or II patients in a major depressive episode to 8 months of double–blind treatment with Lam + placebo or Lam + Div.
- To be eligible for randomization, patients had to achieve control of both depressive and manic symptoms during an open phase that included both Lam and Div.
- Time to depressive episode did not differ significantly by Kaplan–Maier survival analysis (Χ 2 = 1.82, df = 1, P = 0.18).
- However, several secondary outcomes did show significant differences.
- The proportion of Lam + placebo patients who had at least one Montgomery–Asberg Depression Rating Scale (MADRS) score ≥15 during the maintenance phase was 67% (30/45) compared with 44% (18/41) for the Lam + Div group (Χ 2 = 4.51, P = 0.03).
- Among BD I patients assigned to Lam + placebo, 71.4% (25/35) had at least one visit with MADRS score ≥15 compared with 36.7% (11/30) among Lam + Div patients (Χ 2 = 7.89, df = 1, P = 0.005).