LAMOTRIGINE VERSUS LITHIUM AUGMENTATION OF ANTIDEPRESSANT THERAPY IN TREATMENT-RESISTANT DEPRESSION: EFFICACY AND TOLERABILITYReportar como inadecuado




LAMOTRIGINE VERSUS LITHIUM AUGMENTATION OF ANTIDEPRESSANT THERAPY IN TREATMENT-RESISTANT DEPRESSION: EFFICACY AND TOLERABILITY - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Psychiatria Danubina, Vol.21 No.2 March 2009. -

Background: Mood stabilizer augmentation of standard antidepressant drugs has been shown to be effective in treatment-resistant depression. Despite the reported high overall efficacy, lithium has been relatively underused in recent years. Lamotrigine, a novel anticonvulsant recently recognized as a mood stabilizer, seems

to have putative antidepressive properties. The aim of the study was to investigate lamotrigine efficacy and tolerability as antidepressant augmentation for unipolar treatment-resistant depression compared to lithium.

Subjects and methods: 88 patients suffering from treatment-resistant Major depressive disorder, having acute recurrent depressive episodes according to DSMIV criteria, were enrolled in the study. This was an open-label trial with a flexible dosing regimen. All patients, received antidepressants in full therapeutic doses. They were divided into two augmentation groups: 46 patients received 50-200 mg-day lamotrigine, and 42 patients received 600-1200 mg-day lithium. The

Hamilton Rating Scale for Depression HAM-D and The Clinical Global

Impression scale CGI were used to monitor therapeutic efficacy. Patients were evaluated weekly for an 8 week treatment period.

Results: The HAM-D total score was significantly reduced in both treatment groups at the study endpoint, without any difference between the groups. However, significant clinical improvement was reached within the second treatment week in the lamotrigine group compared to the lithium group p=0.01 vs. lithium. Lamotrigine showed significant efficacy on the HAM-D item 1depressed mood;

p=0.01, item 7 work and interest; p=0.01 and CGI-Improvement scale p=0.02. The drop-out rate due to treatment failure was lower in the lamotrigine group n=1 compared to the lithium n=4 group. Also, the incidence of side effects did not differ between the groups.

Conclusions: Our results suggest that lamotrigine could be useful as

augmentation of antidepressants for treatment-resistant unipolar depression. Also, lamotrigine may accelerate the onset of antidepressant action, and therefore might be useful in treatment of major depression in general.

treatment; resistant depression; augmentation strategies; lamotrigine; lithium



Autor: Maja Ivković - ; Institute for Psychiatry, Clinical Center of Serbia, Belgrade, Serbia Aleksandar Damjanović - ; Institute for

Fuente: http://hrcak.srce.hr/



DESCARGAR PDF




Documentos relacionados