Zhihan Gao, Fengli Sun, Wangqiang Lv, Dong Shen, Weidong Jin
Department of Clinical Psychology, Hangzhou First Hospital, Hangzhou, China.
Department of Psychiatry, Zhejiang Province Mental Health Center, Hangzhou, China.
Front Psychiatry. 2022 Jul 14;13:913051. doi: 10.3389/fpsyt.2022.913051. eCollection 2022.
The objective of this study is to observe the effect of combination of lithium and lamotrigine in treatment of rapid-cycling bipolar disorder (RCBD).
We searched MEDLINE, EMBASE, Cochrane Library in English and CBM, CNKI, WANFANG, and CSSCI in Chinese to find literature from 1 January 2000 to 31 December 2020 related to the combination of lithium carbonate and lamotrigine for treatment of RCBD.
Five comparison studies with 265 subjects of 131 cases in a study group and 134 cases in a control group met the inclusion criteria and were included for the final meta-analysis. The comprehensive analysis shows that the study group had a significant lower score in mental symptoms than the control group ( = 2.34, = 0.02) with a random model ( = 33.02, = 7, < 0.01). However, the differences were only shown in PANSS ( = 5.18, < 0.01) and BPRS ( = 3.08, < 0.01). There was no difference in response rate (54.9 vs. 45.7%; OR = 1.47; 95% CI: 0.792.73; = 1.21, > 0.05,) and remission rate (47.9 vs. 45.9%; OR = 1.05; 95% CI: 0.492.25; = 0.13, > 0.05,) found between the two groups. The response rate of lamotrigine and lithium combination was significantly higher compare to that of monotherapy of lithium in patients with no treatment resistant (82 vs. 54%; OR = 4.26; 95% CI: 1.65~10.99; = 3.99, < 0.01) with the fixed effect model ( = 0.89, = 1, > 0.05, = 0%).
The combination of lithium and lamotrigine resulted in better improvement of psychotic symptoms and higher response rate in patients with RCBP with no treatment resistant.
本研究旨在观察锂盐与拉莫三嗪联合治疗快速循环型双相情感障碍（RCBD）的效果。
我们检索了英文的MEDLINE、EMBASE、Cochrane图书馆以及中文的中国生物医学文献数据库（CBM）、中国知网（CNKI）、万方数据库和中文社会科学引文索引（CSSCI），以查找2000年1月1日至2020年12月31日期间与碳酸锂和拉莫三嗪联合治疗RCBD相关的文献。
五项比较研究符合纳入标准，共265名受试者，其中研究组131例，对照组134例，纳入最终的荟萃分析。综合分析显示，随机效应模型下，研究组精神症状评分显著低于对照组（ = 2.34， = 0.02）（ = 33.02， = 7， < 0.01）。然而，差异仅体现在阳性与阴性症状量表（PANSS）（ = 5.18， < 0.01）和简明精神病评定量表（BPRS）（ = 3.08， < 0.01）上。两组在缓解率（54.9%对45.7%；OR = 1.47；95%置信区间：0.792.73； = 1.21， > 0.05）和治愈率（47.9%对45.9%；OR = 1.05；95%置信区间：0.492.25； = 0.13， > 0.05）方面无差异。在未治疗抵抗的患者中，拉莫三嗪与锂盐联合治疗的缓解率显著高于锂盐单药治疗（82%对54%；OR = 4.26；95%置信区间：1.65~$10.99； = 3.99， < 0.01），固定效应模型下（ = 0.89， = 1， > 0.05， = 0%）。
锂盐与拉莫三嗪联合治疗可使未治疗抵抗的RCBP患者的精神病性症状得到更好改善，缓解率更高。
