The British Journal of Psychiatry (2009) 194: 4-9. doi: 10.1192/bjp.bp.107.048504
© 2009 The Royal College of Psychiatrists
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Data supplement
Right arrow Submit an eLetter
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Related articles in BJP
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Geddes, J. R.
Right arrow Articles by Goodwin, G. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Geddes, J. R.
Right arrow Articles by Goodwin, G. M.

REVIEW ARTICLE

Lamotrigine for treatment of bipolar depression: independent meta-analysis and meta-regression of individual patient data from five randomised trials

John R. Geddes, MD FRCPsych

Department of Psychiatry, University of Oxford, UK

Joseph R. Calabrese, MD

Case Western Reserve University, University Hospitals Case Medical Center, Cleveland, Ohio, USA

Guy M. Goodwin, DPhil, FMedSci

Department of Psychiatry, University of Oxford, UK

Correspondence: John R. Geddes, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK. Email: john.geddes{at}psych.ox.ac.uk

Declaration of interest

J.R.C. is a member of the psychiatry advisory board for GlaxoSmithKline. J.R.G. is Chief Investigator and G.M.G. is a co-investigator on the independent Medical Research Council-funded trial: Comparative Evaluation of QUEtiapine-Lamotrigine combination v. quetiapine monotherapy (and folic acid v. placebo) in people with bipolar depression (CEQUEL).

Background

There is uncertainty about the efficacy of lamotrigine in bipolar depressive episodes.

Aims

To synthesise the evidence for the efficacy of lamotrigine in bipolar depressive episodes.

Method

Systematic review and meta-analysis of individual patient data from randomised controlled trials comparing lamotrigine with placebo.

Results

Individual data from 1072 participants from five randomised controlled trials were obtained. More individuals treated with lamotrigine than placebo responded to treatment on both the Hamilton Rating Scale for Depression (HRSD) (relative risk (RR)=1.27, 95% CI 1.09–1.47, P=0.002) and Montgomery–Åsberg Depression Rating Scale (MADRS) (RR=1.22, 95% CI 1.06–1.41, P=0.005). There was an interaction (P=0.04) by baseline severity of depression: lamotrigine was superior to placebo in people with HRSD score >24 (RR=1.47, 95% CI 1.16–1.87, P=0.001) but not in people with HRSD score ≤24 (RR=1.07, 95% CI 0.90–1.27, P=0.445).

Conclusions

There is consistent evidence that lamotrigine has a beneficial effect on depressive symptoms in the depressed phase of bipolar disorder. The overall pool effect was modest, although the advantage over placebo was larger in more severely depressed participants.


Related articles in BJP:

From the Editor’s desk
Peter Tyrer
BJP 2009 194: 100. [Full Text]  

Highlights of this issue
Sukhwinder S. Shergill
BJP 2009 194: A3. [Full Text]  



This article has been cited by other articles:


Home page
 J PsychopharmacolHome page
G. Goodwin and Consensus Group of the British Association for Psy
Evidence-based guidelines for treating bipolar disorder: revised second edition--recommendations from the British Association for Psychopharmacology
J Psychopharmacol, June 1, 2009; 23(4): 346 - 388.
[Abstract] [PDF]