Department of Psychiatry, Isala Klinieken, Location Sophia, Zwolle, the Netherlands.
Acta Psychiatr Scand. 2010 Sep;122(3):246-54. doi: 10.1111/j.1600-0447.2009.01537.x. Epub 2010 Feb 5.
In a previous paper, we reported about the efficacy of the addition of lamotrigine to lithium in patients with bipolar depression. In the second phase of this study paroxetine was added to ongoing treatment in non-responders.
Bipolar depressed patients (n = 124) treated with lithium were randomized to addition of lamotrigine or placebo. In non-responders after 8 weeks, paroxetine 20 mg was added for another 8 weeks to ongoing treatment.
After 8 weeks the improvement in patients treated with lamotrigine vs. patients treated with placebo was significant. After addition of paroxetine this difference disappeared as a result of greater further improvement in the non-responders to placebo.
Addition of lamotrigine to lithium was found effective in bipolar depressed patients. Further addition of paroxetine in non-responders to lithium plus lamotrigine did not appear to provide additional benefit, while it appeared to do so in non-responders to lithium plus placebo.
在之前的一篇论文中，我们报告了在双相抑郁患者中添加拉莫三嗪联合锂治疗的疗效。在这项研究的第二阶段，我们对无应答者添加了帕罗西汀作为辅助治疗。
124 名接受锂治疗的双相抑郁患者被随机分为添加拉莫三嗪或安慰剂组。在 8 周后无应答者中，继续治疗中添加帕罗西汀 20mg，持续 8 周。
在 8 周时，接受拉莫三嗪治疗的患者与接受安慰剂治疗的患者相比，其改善程度显著。加用帕罗西汀后，由于安慰剂组无应答者的进一步改善，这种差异消失了。
在双相抑郁患者中，添加拉莫三嗪联合锂治疗是有效的。对于锂联合拉莫三嗪无应答者进一步添加帕罗西汀似乎没有额外获益，而对于锂联合安慰剂无应答者则似乎有获益。
