Lamotrigine plus Quetiapine Combination Therapy in Treatment-Resistant Bipolar Depression
Abstract
Background Lamotrigine and quetiapine are commonly used in bipolar disorder, but there are no published systematic studies of their use in combination for treatment-resistant bipolar depression. Methods We studied 39 trials in outpatients (15 with bipolar I disorder, 22 with bipolar II disorder, and 1 with bipolar disorder not otherwise specified; 1 patient had 2 trials) with depression resistant to quetiapine or lamotrigine who were taking a mean of 1.7 other prescription psychotropic medications. Patients were given either open-label lamotrigine or quetiapine naturalistically, for up to 12 weeks of combination therapy. Results Lamotrigine (mean dose, 204.2 mg/d) plus quetiapine (mean dose, 188.5 mg/d) increased the euthymia rate (0.0% to 46.2%), decreased syndromal (79.5% to 30.8%) and subsyndromal (20.5% to 15.4%) depression rates, and improved Clinical Global Impression-Severity (mean change, -1.0) and Global Assessment of Functioning (mean change, +5.9) scores. Approximately one-fifth of patients discontinued therapy (20.5%) or required subsequent additional pharmacotherapy (20.5%). Only 10.3% discontinued due to adverse effects, and there was no significant change in mean body weight. Conclusions The findings of this uncontrolled open pilot study must be viewed with caution. However, randomized, double-blind, placebo-controlled studies are warranted to confirm the possibility that combination therapy with lamotrigine and quetiapine is effective and well tolerated in pat…
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Open-label studies suggest efficacy for adjunctive quetiapine in acute bipolar II depression.
“Finally, open‐label studies also suggest efficacy for adjunctive quetiapine (level 4).441, 442”
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- Authors
- Ahn, Y. M., Nam, J. Y., Culver, J. L., Marsh, W. K., Bonner, J. C., & Ketter, T. A.
- Affiliations
- Seoul National University (KR)
- University of Miami (US)
- Stanford Medicine (US)
- Corresponding author
- Ketter, Terence A.
- Venue
- Annals of Clinical Psychiatry
- Publisher
- SAGE Publications
- Published
- 2011-02
- Volume
- 23
- Issue
- 1
- Pages
- 17-24
- ISSN
- 1040-1237 (ISSN-L)
- 1547-3325
- OpenAlex
- W2112682118
- Cited by
- 23
- References
- 32
- Citations by year
- 2024: 3 · 2023: 1 · 2020: 1 · 2018: 2 · 2017: 1 · 2015: 5 · 2014: 2 · 2013: 3 · 2012: 4
- FWCI
- 2.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- eScholarship@UMassChan (submittedVersion)
- PubMed
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- lamotrigine, quetiapine, combination therapy, treatment-resistant depression, bipolar depression, bipolar I disorder, bipolar II disorder, euthymia, adverse effects, treatment discontinuation, antipsychotic augmentation
- MeSH terms
- Quetiapine Fumarate, Lamotrigine, Adult, Affect, Bipolar Disorder, Dibenzothiazepines, Drug Resistance, Drug Therapy, Combination, Female, Humans, Interview, Psychological, Male, Middle Aged, Monitoring, Physiologic, Pilot Projects, Psychiatric Status Rating Scales, Severity of Illness Index, Antipsychotic Agents, Triazines, Xerostomia, Treatment Outcome, Antimanic Agents, Diagnostic and Statistical Manual of Mental Disorders
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