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Bipolar depression continues to be difficult to treat: Only quetiapine, fluoxetine–olanzapine combination, and lurasidone have shown unequivocal short-term efficacy. Evidence for benefit with lamotrigine has been mixed. Researchers conducted a 1-year, placebo-controlled study of the efficacy of adjunctive lamotrigine (200 mg/day) in 202 patients with bipolar depression (approximately 75% with bipolar disorder type I). All participants were taking quetiapine (150–300 mg/day).
The researchers also compared effects of folic acid, a possibly effective agent for depression, versus placebo in the study, which used a 2×2 factorial design and an adaptive randomization process to balance clinical factors between groups. Many patients were taking othe…