Cochrane · systematic review · CD013575
Lamotrigine in the maintenance treatment of bipolar disorder
Hashimoto, Y, Kotake, K, Watanabe, N, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
Common Mental DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
26
current version
GRADE rated
17
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 9 · 34.6%Very low 4 · 15.4%Low 3 · 11.5%Moderate 10 · 38.5%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Lamotrigine versus placebo for the maintenance treatment of bipolar disorder
Population: bipolar disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrence of any episodes at one year (hospitalization for any episodes) Lamotrigine vs placebo | no estimate extracted | 0 studies · 0 participants | Ungraded |
Recurrence of any episodes at one year (Young Mania Rating Scale (YMRS) total score ≥15 for manic episode) Lamotrigine vs placebo | RR 0.67 [0.51, 0.87] | 3 studies · 663 participants | Low Downgraded: publication bias |
Recurrence of any episodes at one year (Montgomery‐Asberg Depression Rating Scale (MADRS) total score ≥15 for depressive episode; Hamilton Depression Rating Scale (HDRS) total score ≥14 for depressive episode) Lamotrigine vs placebo | RR 0.85 [0.7, 1.02] | 7 studies · 1606 participants | Low Downgraded: publication bias |
Recurrence of any episodes at one year for clinical worsening with additional psychotropics (mood stabilizers, antidepressants, antipsychotics or benzodiazepines) Lamotrigine vs placebo | RR 0.82 [0.7, 0.98] | 4 studies · 756 participants | Moderate Downgraded: publication bias |
Recurrence of any episodes at one year (active suicidal behavior) Lamotrigine vs placebo | no estimate extracted | 1 study · 1 participants | Ungraded |
Withdrawal from treatment due to any reason, up to 12 weeks after intervention commencement (short term) Lamotrigine vs placebo | RR 1.1 [0.7, 1.74] | 1 study · 195 participants | Very low Downgraded: publication bias |
Withdrawal from treatment due to any reason, 6‐12 months after intervention initiation (long term) Lamotrigine vs placebo | RR 0.88 [0.78, 0.99] | 4 studies · 700 participants | Moderate Downgraded: publication bias |
Any reported adverse effects up to 12 weeks after starting treatment (short term) Lamotrigine vs placebo | RR 1.07 [0.81, 1.42] | 5 studies · 1138 participants | Very low Downgraded: publication bias |
Any reported adverse effects 6‐12 months after initiating the intervention (long term) Lamotrigine vs placebo | RR 0.97 [0.77, 1.23] | 4 studies · 756 participants | Moderate Downgraded: publication bias |
Recurrence of manic episode at one year Lamotrigine vs placebo | RR 0.91 [0.66, 1.26] | 3 studies · 574 participants | Moderate Downgraded: publication bias |
Recurrence of depressive episode at one year Lamotrigine vs placebo | RR 0.75 [0.53, 1.05] | 3 studies · 574 participants | Moderate Downgraded: publication bias |
Quality of life as measured by the 36‐Item Short Form Health Survey Lamotrigine vs placebo | no estimate extracted | 0 studies · 0 participants | Ungraded |
Total severity score from depression and mania symptom scores, such as HDRS and the YMRS Lamotrigine vs placebo | no estimate extracted | 0 studies · 0 participants | Ungraded |
Lamotrigine versus lithium for the maintenance treatment of bipolar disorder
Population: bipolar disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrence of any episodes at one year (hospitalization for any episodes) Lamotrigine vs lithium | no estimate extracted | 0 studies · 0 participants | Ungraded |
Recurrence of any episodes at one year (Young Mania Rating Scale (YMRS) total score ≥15 for manic episode) Lamotrigine vs lithium | RR 3.57 [0.15, 85.39] | 2 studies · 376 participants | Very low Downgraded: risk of bias |
Recurrence of any episodes at one year (Montgomery‐Asberg Depression Rating Scale (MADRS) total score ≥15 for depressive episode; Hamilton Depression Rating Scale (HDRS) total score ≥14 for depressive episode) Lamotrigine vs lithium | RR 1.4 [0.7, 2.79] | 2 studies · 376 participants | Low Downgraded: risk of bias |
Recurrence of any episodes at one year for clinical worsening with additional psychotropics (mood stabilizers, antidepressants, antipsychotics or benzodiazepines) Lamotrigine vs lithium | RR 1.11 [0.92, 1.35] | 3 studies · 602 participants | Moderate Downgraded: risk of bias, imprecision, publication bias |
Recurrence of any episodes at one year (active suicidal behavior) Lamotrigine vs lithium | RR 1.01 [0.06, 15.91] | 1 study · 155 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Withdrawal from treatment due to any reason, up to 12 weeks after intervention commencement (short term) Lamotrigine vs lithium | no estimate extracted | 0 studies · 0 participants | Ungraded |
Withdrawal from treatment due to any reason, 6‐12 months after intervention initiation (long term) Lamotrigine vs lithium | RR 0.96 [0.88, 1.05] | 4 studies · 636 participants | Moderate Downgraded: risk of bias, imprecision, publication bias |
Any reported adverse effects up to 12 weeks after starting treatment (short term) Lamotrigine vs lithium | no estimate extracted | 0 studies · 0 participants | Ungraded |
Any reported adverse effects 6‐12 months after initiating the intervention (long term) Lamotrigine vs lithium | RR 0.7 [0.51, 0.96] | 4 studies · 691 participants | Moderate Downgraded: risk of bias, imprecision, publication bias |
Recurrence of manic episode at one year Lamotrigine vs lithium | RR 2.13 [1.32, 3.44] | 3 studies · 602 participants | Moderate Downgraded: risk of bias, imprecision, publication bias |
Recurrence of depressive episode at one year Lamotrigine vs lithium | RR 0.83 [0.63, 1.09] | 3 studies · 602 participants | Moderate Downgraded: risk of bias, imprecision, publication bias |
Quality of life as measured by the 36‐Item Short Form Health Survey Lamotrigine vs lithium | no estimate extracted | 0 studies · 0 participants | Ungraded |
Total severity score from depression and mania symptom scores, such as HDRS and the YMRS Lamotrigine vs lithium | no estimate extracted | 0 studies · 0 participants | Ungraded |