Effect of lamotrigine on depressive symptoms in adult patients with epilepsy
Effect of lamotrigine on depressive symptoms in adult patients with epilepsy
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DOI：
10.1016/j.yebeh.2006.09.008
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发表时间：
2007-02-01
影响因子：
2.6
通讯作者：
Hammer, Anne E.
中科院分区：
文献类型：
--
作者：
Ettinger, Alan B.;Kustra, Robert P.;Hammer, Anne E.
在这项研究中，拉莫三嗪与安慰剂对癫痫患者抑郁症状的影响进行了前瞻性评估。本研究是一项随机、双盲、安慰剂对照、平行组研究的次要分析，在该研究中，成人患者接受拉莫三嗪（n = 32）或安慰剂（n = 38）连续治疗原发性全身强直阵挛（PGTC）癫痫发作，为期7周的剂量递增期，随后为12周的维持期。采用贝克抑郁量表第二版（BDI-II）、心境状态量表（POMS）和康奈尔心境恶劣评定量表自我报告（CDRS）评估心境症状。筛选时的平均（SD）BDI-II评分反映了轻度抑郁症状，两组之间相似（拉莫三嗪18.3（12.1），安慰剂16.8（12.0））。在维持治疗期结束时，拉莫三嗪组BDI-II评分较基线的平均（SD）改善大于安慰剂组（拉莫三嗪8.9（7.6），安慰剂1.7（8.5），P = 0.01）和POMS总分（拉莫三嗪32.0（30.4），安慰剂6.5拉莫三嗪组的CDRS评分在数值上大于安慰剂组（拉莫三嗪组7.3（7.8），安慰剂组4.1（13.9），P = 0.50）。在至少有轻度抑郁的患者亚组（BDI-II评分≥ 10）中，拉莫三嗪组（11.5，n = 13）较安慰剂组（3.1，n = 18）较基线的平均改善在数值上但无统计学显著性（P = 0.054）。对于PGTC癫痫发作和所有全身性癫痫发作，在递增阶段、维持阶段以及递增和维持阶段合并，拉莫三嗪组癫痫发作频率的中位百分比降低显著大于安慰剂组。然而，癫痫发作频率的改善与情绪的改善不相关（r = 0.1，P = ns）。与安慰剂相比，拉莫三嗪改善了全身性癫痫发作患者的情绪症状，与癫痫发作减少无关。拉莫三嗪可能是有用的治疗癫痫和共病抑郁症状的患者。(c)2006年爱思唯尔公司All rights reserved.
In this investigation, the effects of lamotrigine versus placebo on depressive symptoms in patients with epilepsy were prospectively assessed. This investigation was a secondary analysis of a randomized, double-blind, placebo-controlled, parallel-group study in which adult patients received adjunctive lamotrigine (n = 32) or placebo (n = 38) for a 7-week dose escalation phase, followed by a 12-week maintenance phase, for primary generalized tonic-clonic (PGTC) seizures. Mood symptoms were assessed with the Beck Depression Inventory, second edition (BDI-II), the Profile of Mood States (POMS), and the Cornell Dysthymia Rating Scale-Self-Report (CDRS). Mean (SD) BDI-II scores at screening reflected mild depressive symptoms and were similar between groups (lamotrigine 18.3 (12.1), placebo 16.8 (12.0)). At the end of the maintenance phase, mean (SD) improvement from baseline was greater with lamotrigine than placebo with respect to BDI-II score (lamotrigine 8.9 (7.6), placebo 1.7 (8.5), P = 0.01) and POMS total score (lamotrigine 32.0 (30.4), placebo 6.5 (32.3), P = 0.03) and numerically greater with lamotrigine than placebo for CDRS score (lamotrigine 7.3 (7.8), placebo 4.1 (13.9), P = 0.50). Among the subset of patients with at least mild depression (BDI-II score >= 10), mean improvement from baseline was numerically, but not statistically significantly, greater with lamotrigine (11.5, n = 13) than placebo (3.1, n = 18) (P = 0.054). Median percentage reductions in seizure frequency were significantly greater with lamotrigine than placebo during the escalation phase, the maintenance phase, and the escalation and maintenance phases combined for PGTC seizures and all generalized seizures. However, improvement in seizure frequency was not correlated with improvement in mood (r = 0.1, P = ns). Compared with placebo, lamotrigine improved mood symptoms independently of seizure reduction in patients with generalized seizures. Lamotrigine may be useful in treating patients with epilepsy and comorbid depressive symptoms. (c) 2006 Elsevier Inc. All rights reserved.