拉莫三嗪在中国人群中治疗双相抑郁时预防转躁的Meta分析

Meta-analysis of the mania switch preventive effectiveness of lamotrigine in the treatment of bipolar depression in Chinese population

目的:评价拉莫三嗪在治疗双相抑郁过程中预防转躁效应。方法:在中英文数据库中以“拉莫三嗪、双相障碍(双相抑郁)”进行检索,对符合标准的7篇论文,共8项研究进行分析。采用循证医学方法进行统计,评价拉莫三嗪预防转躁的作用以及拉莫三嗪与其他心境稳定剂预防转躁作用的比较。结果:与不用拉莫三嗪相比,拉莫三嗪明显降低转躁率(7/141 vs 25/137,OR=0.24,95%CI:0.10~0.57,Z=3.80,P=0.001);与其他心境稳定剂相比,转躁率差异无统计学意义(5/158 vs 5/152,OR=1.02,95%CI:0.26~3.97,Z=0.04,P=0.97)。结论:拉莫三嗪可明显降低转躁风险,预防转躁的效应与其他心境稳定剂相似。

Objective:To evaluate the preventive effectiveness of mania switch of lamotrigine on bipolar depression.Method:Both English and Chinese literature databases were searched with"lamotrigine,bipolar disorder(bipolar depression)",7 papers met the criteria,a total of 8 studies were analyzed,and the evidence-based medicine method was used for statistics to evaluate the preventive effect of lamotrigine on the mania switch and to make the comparison between lamotrigine and other mood stabilizers on mania switch.Results:Compared with no lamotrigine,lamotrigine significantly reduced the manic conversion rate(7/141 vs 25/137,OR=0.24,95%CI:0.10-0.57,Z=3.80,P=0.001).Compared with other mood stabilizers,there was no difference in manic conversion rate(5/158 vs 5/152,OR=1.02,95%CI:0.26-3.97,Z=0.04,P=0.97).Conclusion:Lamotrigine can significantly reduce the risk of manic switch,and the effect of preventing manic switch is similar to that of other mood stabilizers.