{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T03:02:52Z","timestamp":1773975772404,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,12,17]],"date-time":"2018-12-17T00:00:00Z","timestamp":1545004800000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["81651"],"award-info":[{"award-number":["81651"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Although not licensed for acute bipolar depression, lamotrigine has evidence for efficacy in trials and its use is recommended in guidelines. So far there had been no prospective health economic evaluation of its use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cost\u2010utility analysis of the CEQUEL trial comparing quetiapine plus lamotrigine vs quetiapine monotherapy (and folic acid vs placebo in an add\u2010on factorial design) for patients with bipolar depression (n\u00a0=\u00a0201) from the health and social care perspective. Differences in costs together with quality\u2010adjusted life years (QALYs) between the groups were assessed over 52\u00a0weeks using a regression\u2010based approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Health\u2010related quality of life improved substantially for all randomization groups during follow\u2010up with no significant difference in QALYs between any of the comparisons (mean adjusted QALY difference: lamotrigine vs placebo \u22120.001 (95% CI: \u22120.05 to 0.05), folic acid vs placebo 0.002 (95% CI: \u22120.05 to 0.05)). While medication costs in the lamotrigine group were higher than in the placebo group (\u00a3647, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), mental health community\/outpatient costs were significantly lower (\u2212\u00a3670, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Mean total costs were similar in the groups (\u2212\u00a3180, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.913).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Lamotrigine improved clinical ratings in bipolar depression compared with placebo. This differential effect was not detected using the EQ\u20105D\u20103L. The additional cost of lamotrigine was balanced by significant savings in some other medical costs which made its use cost neutral to the health service. Compared to placebo, folic acid produced neither clinical nor significant health economic benefits. The study supports the use of lamotrigine in combination with other drugs to treat bipolar depression.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12713","type":"journal-article","created":{"date-parts":[[2018,10,30]],"date-time":"2018-10-30T13:28:26Z","timestamp":1540906106000},"page":"733-745","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Comparative economic evaluation of quetiapine plus lamotrigine combination vs quetiapine monotherapy (and folic acid vs placebo) in patients with bipolar depression (CEQUEL)"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9279-8627","authenticated-orcid":false,"given":"Judit","family":"Simon","sequence":"first","affiliation":[{"name":"Department of Health Economics, Center for Public Health Medical University of Vienna Vienna Austria"},{"name":"Department of Psychiatry University of Oxford and Oxford Health NHS Trust, Warneford Hospital Oxford UK"},{"name":"Health Economics Research Centre, Nuffield Department of Population Health University of Oxford Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John R.","family":"Geddes","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Oxford and Oxford Health NHS Trust, Warneford Hospital Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Gardiner","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Oxford and Oxford Health NHS Trust, Warneford Hospital Oxford UK"},{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Rendell","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Oxford and Oxford Health NHS Trust, Warneford Hospital Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guy M.","family":"Goodwin","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Oxford and Oxford Health NHS Trust, Warneford Hospital Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"Mayer","sequence":"additional","affiliation":[{"name":"Department of Health Economics, Center for Public Health Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,12,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61611-6"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61729-2"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12296"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.2165\/00023210-200317070-00003"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-3-72"},{"issue":"9","key":"e_1_2_9_7_1","first-page":"S275","article-title":"Bipolar disorder: quality of life and the impact of atypical antipsychotics","volume":"11","author":"Vornik LA","year":"2005","journal-title":"Am J Manag Care"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12165"},{"key":"e_1_2_9_9_1","unstructured":"National Collaborating Centre for Mental Health.Bipolar disorder: assessment and management.2016.https:\/\/www.nice.org.uk\/guidance\/cg185. 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