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Bipolar depression remains the most difficult phase of illness to treat in bipolar patients and constitutes an increasingly larger proportion of the illness as patients grow older. In a recent meta-analysis, lamotrigine monotherapy had positive results on secondary outcomes in only one of the five available randomized studies. This multicenter, industry-sponsored, randomized trial answers the question of lamotrigine’s efficacy when combined with a mood stabilizer.
The researchers randomized 124 bipolar patients in the depressed phase, all taking therapeutic levels of lithium for at least 2 weeks (79% for ≥1 month), to adjunctive lamotrigine (slowly titrated to 200 mg over 7 weeks) or placebo. Compared with placebo, lamotrigine was associated…