Lamotrigine and Lithium Combination for Treatment of Rapid Cycling Bipolar Disorder: Results From Meta-analysis

Abstract

Objective: to observe effect of combination of lithium and lamotrigine in treatment for Rapid-cycling bipolar disorder(RCBD). Method: We searched both MEDLINE, EMBASE, Cochrane Library in English and CBM, CNKI, WANFANG and CSSCI in Chinese to find literature from January 1 2000 to December 31, 2020 related to combination of lithium carbonate and lamotrigine for treatment of RCBD.Results: Five comparison studies, with 265 subjects of 131 cases in study group and 134 cases in control group met the inclusion criteria and were included for the final meta-analysis. The comprehensive analysis show that study group had significant lower score of mental symptoms than that of control group (Z=2.34, P=0.02) by random model (X2=33.02, df=7, P<0.01).But these differences only were shown in PANSS (Z=5.18, P<0.01) and BPRS (Z=3.08, P<0.01).The no difference in response rate (54.9% vs 45.7%OR=1.47, 95% CI: 0.79~2.73, Z=1.21, P> 0.05,) and remission rate (47.9% vs 45.9%OR=1.05, 95% CI: 0.49~2.25, Z=0.13, P> 0.05,) were found between two groups. The response rate of lamotrigine and lithium combination was significant higher compare to monotherapy of lithium in patients with no treatment-resistant (82% V 54%, OR=4.26,95% CI: 1.65~10.99, Z=3.99, P< 0.01) by fixed effect model (X2=0.89, df=1, P>0.05, I2 =0%).Conclusion: Combination of lithium and lamotrigine have better improvement of psychotic symptoms and higher response rate in patients of RCBP with no treatment-resistant.