Evaluation of the efficacy of adjunctive lamotrigine in the treatment of epilepsy and depression with Meta-analysis

摘要

Objective To evaluate the efficacy of adjunctive lamotrigine in the treatment of patients with epilepsy and comorbid depressive symptoms. Methods Relevant clinical trials were searched via PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI) and Wanfang Data from January 1998 to June 2014 using the following retrieval words: lamotrigine, epilepsy and depressive both in Chinese and English. The Cochrane Handbook for Systematic Reviews of Interventions (Version 5.0.2) was used to evaluate the quality of randomized controlled trials (RCTs). Two reviewers independently evaluated the quality of included articles and abstracted the data. Meta-analysis was conducted using RevMan 5.1.1 software. Results According to the inclusion criteria, 3 prospective clinical trials with a total of 668 patients were finally selected. The Meta-analysis showed the Beck Depression Inventory-Ⅱ (BDI-Ⅱ) score ( MD =?- 8.400, 95%CI:?- 10.890— -?5.920; P = 0.000), Cornell Dysthymia Rating Scale (CDRS) score ( MD =?- 8.240, 95% CI:?- 11.180— - 5.290; P = 0.000) and Profile of Mood States (POMS) score ( MD =?- 24.210, 95%CI:?- 30.740— -?17.680; P = 0.000) in lamotrigine group were significantly improved compared to those in control group. As for 6 mood states in POMS, the scores of tension-anxiety ( MD =?- 3.360, 95%CI:?- 4.620—?- 2.100; P = 0.000), depression-dejection ( MD =?- 5.490, 95%CI:?- 7.420— - 3.560; P = 0.000), anger-hostility (MD =?- 3.870, 95%CI:?- 5.510—?- 2.230; P = 0.000), fatigue-inertia ( MD =?- 4.480, 95%CI:?- 5.630—?- 3.320; P = 0.000), confusion-bewilderment ( MD =?- 2.720, 95%CI:?- 3.730—?- 1.720; P = 0.000) in lamotrigine group were all significantly lower than those in control group, while the score of vigor-activity ( MD = 3.970, 95% CI: 2.870-5.070; P = 0.000) was significantly higher than that in control group. Conclusions The effect of adjunctive lamotrigine in the treatment of patients with epilepsy and depression is favorable. The most common side effects include rash and stimulation of central nervous system. DOI: 10.3969/j.issn.1672-6731.2016.01.005