{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:48:48Z","timestamp":1793119728299,"version":"4.5.0"},"reference-count":49,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T00:00:00Z","timestamp":1715731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To provide up\u2010to\u2010date clinical guidance on the efficacy of lamotrigine in bipolar disorder (BD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eligible studies were identified during a systematic literature search according to PRISMA\u2010guidelines. We included randomized controlled trials (RCTs) and cohort studies that quantitatively assessed lamotrigine's efficacy in BD. We divided the included studies into three groups: 1. acute treatment of depression, 2. acute treatment of mania and hypomania, and 3. maintenance treatment. Analyses were stratified by control group (placebo vs active comparator) and treatment strategy (monotherapy vs add\u2010on treatment).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 20 RCTs (<jats:italic>n<\/jats:italic>\u2009=\u20091166 lamotrigine users) and 20 cohort studies (<jats:italic>n<\/jats:italic>\u2009=\u200911,141 lamotrigine users). Twenty\u2010four of these studies were included in meta\u2010analyses. During depressive episodes, greater decreases in depressive symptomatology were associated with initiation of lamotrigine as add\u2010on treatment than with placebo (SMD \u22120.30 [95% CI\u2009=\u2009\u22120.51, \u22120.10], df\u2009=\u20093, <jats:italic>p<\/jats:italic>\u2009=\u20090.004). Decreases in depressive symptomatology did not differ significantly between lamotrigine and the active comparator (SMD \u22120.28 [95% CI\u2009=\u2009\u22121.06, 0.50], df\u2009=\u20093, <jats:italic>p<\/jats:italic>\u2009=\u20090.488).<\/jats:p><jats:p>As a maintenance treatment, lamotrigine was associated with a significantly lower relapse\/recurrence rate than placebo (risk ratio (RR) 0.84 [95% CI\u2009=\u20090.71, 0.99], df\u2009=\u20092, <jats:italic>p<\/jats:italic>\u2009=\u20090.037). Relapse\/recurrence rates did not differ significantly between lamotrigine and lithium (RR 1.06 [95% CI\u2009=\u20090.89, 1.25], df\u2009=\u20092, <jats:italic>p<\/jats:italic>\u2009=\u20090.513). A qualitative assessment of high\u2010quality register\u2010based studies found that lamotrigine was associated with lower hospital admission rates than other commonly used treatment regimes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is substantial evidence for the efficacy of lamotrigine in BD, specifically as add\u2010on treatment during acute depressive episodes and as maintenance treatment for preventing relapse and recurrence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.13452","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T03:59:46Z","timestamp":1715831986000},"page":"431-441","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["The efficacy of lamotrigine in bipolar disorder: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"26","author":[{"given":"N.","family":"Haenen","sequence":"first","affiliation":[{"name":"Department of Psychiatry Erasmus University Medical Center  Rotterdam the Netherlands"},{"name":"The Netherlands Institute for Forensic Psychiatry and Psychology (NIFP) Penitentiary Psychiatric Centre (PPC)  Vught the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4455-6492","authenticated-orcid":false,"given":"A. M.","family":"Kamperman","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Erasmus University Medical Center  Rotterdam the Netherlands"},{"name":"Department of Psychiatry, Epidemiological and Social Psychiatric Research Institute (ESPRi) Erasmus University Medical Center  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Prodan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, UMC Utrecht Brain Center University Medical Center  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. A.","family":"Nolen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University Medical Center Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. P.","family":"Boks","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, UMC Utrecht Brain Center University Medical Center  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0298-3728","authenticated-orcid":false,"given":"R.","family":"Wesseloo","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Erasmus University Medical Center  Rotterdam the Netherlands"},{"name":"Bipolar Disorder Expert Team, GGZ Delfland  Delft the 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