RESUMO
Objective: The objective of this study is to observe the effect of combination of lithium and lamotrigine in treatment of rapid-cycling bipolar disorder (RCBD). Method: We searched MEDLINE, EMBASE, Cochrane Library in English and CBM, CNKI, WANFANG, and CSSCI in Chinese to find literature from 1 January 2000 to 31 December 2020 related to the combination of lithium carbonate and lamotrigine for treatment of RCBD. Results: Five comparison studies with 265 subjects of 131 cases in a study group and 134 cases in a control group met the inclusion criteria and were included for the final meta-analysis. The comprehensive analysis shows that the study group had a significant lower score in mental symptoms than the control group (Z = 2.34, P = 0.02) with a random model (X 2 = 33.02, df = 7, P < 0.01). However, the differences were only shown in PANSS (Z = 5.18, P < 0.01) and BPRS (Z = 3.08, P < 0.01). There was no difference in response rate (54.9 vs. 45.7%; OR = 1.47; 95% CI: 0.79~2.73; Z = 1.21, P > 0.05,) and remission rate (47.9 vs. 45.9%; OR = 1.05; 95% CI: 0.49~2.25; Z = 0.13, P > 0.05,) found between the two groups. The response rate of lamotrigine and lithium combination was significantly higher compare to that of monotherapy of lithium in patients with no treatment resistant (82 vs. 54%; OR = 4.26; 95% CI: 1.65~10.99; Z = 3.99, P < 0.01) with the fixed effect model (X 2 = 0.89, df = 1, P > 0.05, I 2 = 0%). Conclusion: The combination of lithium and lamotrigine resulted in better improvement of psychotic symptoms and higher response rate in patients with RCBP with no treatment resistant.
RESUMO
PRIMARY OBJECTIVE: The aim of this study was to identify and understand the syndromes of mania in traditional Chinese medicine (TCM), as described in Chinese literature on the integrated treatment of mania using TCM and Western medicine. METHODS: A literature search conducted in Chinese databases identified 27 articles that were included in a statistical analysis to determine the proportion of mania cases represented by various TCM syndromes. RESULTS: After combining similar syndromes, we found that the TCM syndromes of mania could be categorized as phlegm-fire disturbance of the mind (Tanhuoraoshen), phlegm-heat stagnation (Tanreyujie), qi stagnation and blood stasis (Qizhixueyu), liver qi stagnation (Gandanyure), and fire injury Yin (Huoshengshnagyin). These syndrome categories accounted for 55.6%, 18.5%, 14.8%, 7.4% and 3.7% of mania cases, respectively. Manic symptom severity scores differed significantly among phlegm-fire disturbance of the mind (26.8 ± 1.6), phlegm-heat stagnation (31.1 ± 1.9), and qi stagnation and blood stasis (23.5 ± 2.2). CONCLUSION: The largest proportion of mania cases involved phlegm-fire disturbance of the mind, phlegm-heat stagnation, or qi stagnation and blood stasis. Cumulatively, these syndromes accounted for 88.9% of cases; the severity of manic symptoms different significantly among the 3 syndrome categories. Smaller proportions of cases represented liver qi stagnation or fire injury Yin.
