拉莫三嗪联合抗抑郁药物治疗双相抑郁的研究:国内文献Meta分析

Meta-analysis of clinical effects and switching rate of lamotrigine and antidepressants in treatment of bipolar depression

目的评价拉莫三嗪联合抗抑郁药物与单一使用抗抑郁药物治疗双相抑郁症的疗效与安全性。方法应用循证医学方法对符合标准的5项研究进行分析,评价拉莫三嗪联合抗抑郁药物与单一使用抗抑郁药物治疗双相抑郁的有效率、症状学变化以及转相率的差异。结果拉莫三嗪联合抗抑郁药物与单一使用抗抑郁药物相比,症状改善更为明显(WMD=-1.81,95%CI:-2.64^-1.71,Z=5.52,P<0.01),有效率较高(59/109 vs.35/106,OR=2.43,95%CI:1.38~4.27,Z=3.08,P<0.01),而且也显著降低了联合组的转相率(7/86vs.21/85,OR=0.26,95%CI=0.10-0.66,Z=2.86,P<0.01)。结论拉莫三嗪联合抗抑郁药物不仅可以增加治疗效应,而且也降低了转相风险。

Objective To assess the difference in therapy efficacy and safety between lamotrigine adding antidepressants and single antidepressant in treatment of bipolar depression. Methods studies meeting our criteria were analyzed by based-evidence medicine,comparing the difference in symptoms changes,efficacy rate,and switching rate. Results The decreasing of symptoms scale in combined group was more significant than that of single antidepressant( WMD =-1. 81,95% CI:-2. 64 ^-1. 71,Z = 5. 52,P <0. 01),and effective rate in combined group was more higher than that of single antidepressants( 59 /109 vs 35 /106,OR = 2. 43,95%CI: 1. 38 ~ 4. 27,Z = 3. 08,P < 0. 01),And switching rate in combined group was more lower than that of single antidepressants( 7 /86 vs. 21 /85,OR = 0. 2,95% CI = 0. 10-0. 66,Z = 2. 86,P < 0. 01). Conclusion Lamotrigine adding antidepressant may promote treating efficacy,and decrease switching.