Lamotrigine vs. lamotrigine plus divalproex in randomized, placebo-controlled maintenance treatment for bipolar depression

C. L. Bowden, V. Singh, R. Weisler, P. Thompson, X. Chang, M. Quinones, J. Mintz

Research output: Contribution to journalArticle

10 Scopus citations


Objective: To compare the maintenance efficacy of lamotrigine (Lam) to combination therapy of Lam+divalproex ER (Div) in recently depressed patients with bipolar disorder (BD). Method: We randomized 86 BD I or II patients in a major depressive episode to 8months of double-blind treatment with Lam+placebo or Lam+Div. To be eligible for randomization, patients had to achieve control of both depressive and manic symptoms during an open phase that included both Lam and Div. Results: Time to depressive episode did not differ significantly by Kaplan-Maier survival analysis (χ2=1.82, df=1, P=0.18). However, several secondary outcomes did show significant differences. The proportion of Lam+placebo patients who had at least one Montgomery-Asberg Depression Rating Scale (MADRS) score ≥15 during the maintenance phase was 67% (30/45) compared with 44% (18/41) for the Lam+Div group (χ2=4.51, P=0.03). Among BD I patients assigned to Lam+placebo, 71.4% (25/35) had at least one visit with MADRS score ≥15 compared with 36.7% (11/30) among Lam+Div patients (χ2=7.89, df=1, P=0.005). Conclusion: Lam+Div generally provided greater maintenance efficacy than Lam alone for depressive indices in recently depressed BD patients.

Original languageEnglish (US)
Pages (from-to)342-350
Number of pages9
JournalActa Psychiatrica Scandinavica
Issue number5
StatePublished - Nov 1 2012



  • Affective disorders
  • Bipolar disorder
  • Treatment

ASJC Scopus subject areas

  • Psychiatry and Mental health

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