Study Of Lamotrigine Efficacy On Patients With Epilepsy Incorporate In Depressive Disorder

Purpose:To investigate the efficacy of lamotrigine on mild and moderate depression symptoms of patients with epilepsy, and to seek for reference of therapy for these patients.Methods:Seventy-two in-patients and out-patients diagnosed with epilepsy incorporate in mild and moderate depressive disorder were investigated at department of neurology in First Affiliated Hospital of Kunming Medical University from March,2011to March,2012. These patients were divided into two groups:lamotrigine group (the case group) and valproate group (the control group), and there were thirty-six cases in each group. In this study, patients received lamotrigine25～100mg/d or valproate500～1000mg/d for a8-week dose escalation phase, followed by a8-week maintenance phase in which patients received lamotrigine100mg/d or valproate500～1000mg/d. Depression symptoms were assessed with17Hamilton Depression Rating Scale (HAMD-17) and Montgmery-Asberg Depression Rating Scale (MADRS). Scales scores and seizure frequency were recorded at baseline phase, the end of the eighth week and the end of the sixteenth week. These data were statistically analyzed with the newest statistics package-SPSS17.0.Results:Compared with baseline phase, improvement at the end of the eighth week and the end of the sixteenth week were significant in lamotrigine group and valproate group with respect to HAMD-17total score and MADRS total score (P<0.05, difference was significant). Comparison between the two groups (lamotrigine group and valproate group):Difference was not significant at baseline phase with respect to HAMD-17total score and MADRS total score (P>0.05). At the end of the eighth week, scores of improvement from baseline was not significant with respect to HAMD-17total score and MADRS total score (P>0.05). At the end of the sixteenth week, scores of improvement from baseline was significant with respect to HAMD-17total score and MADRS total score (P<0.05). These data suggest that lamotrigine and valproate improved mild and moderate depression symptoms in patients with epilepsy, and lamotrigine was more effective than valproate in decreasing scales scores. Comparison with efficacy of the two antiepileptic drugs was analyzed. At the end of the eighth week:complete control(lamotrigine0(0%), valproate0(0%)),significant effect(lamotrigine2(5.6%), valproate0(0%)), effect (lamotrigine10(27.8%), valproate7(19.4%))and invalid effect(lamotrigine24(66.7%),valproate29(80.6%)). Rank sum test suggest P>0.05, and difference was not significant. At the end of the sixteenth week:complete control(lamotrigine11(30.6%), valproate9(25.0%)), significant effect(lamotrigine8(22.2%), valproate10(27.8%)), effect (lamotrigine14(38.9%), valproate13(36.1%))and invalid effect(lamotrigine3(8.3%), valproate4(11.1%)).Rank sum test suggest P>0.05, and difference was not significant. These data suggest that there were no significant differences in complete control rate, significant effect rate, effect rate and invalid effect rate between the two groups(P>0.05). Lamotrigine and valproate could decrease the seizure frequencies and there was no significant difference of efficacy of the two drugs.Conclusions:Lamotrigine and valproate decreased the seizure frequencies in patients with epilepsy. Compared with valproate, lamotrigine improved mild and moderate depression symptoms of patients with epilepsy better. Lamotrigine is a good choice in treating patients with epilepsy incorporate in mild and moderate depressive disorder.