치료저항성 주요우울장애 환자의 라모트리진 강화요법： 자연관찰연구 (Lamotrigine Augmentation in Patients with Treatment-Resistant Major Depressive Disorder：A Naturalistic Study)

서지정보

· 발행기관 : 대한정신약물학회
· 수록지 정보 : 대한정신약물학회지 / 19권 / 5호 / 276 ~ 282페이지
· 저자명 : 장재승, 조수현, 차보석, 문은수, 하태현, 윤인영, 하규섭

초록

이번 연구는 임상 실제에서 치료저항성 주요우울장애
환자를 대상으로 8주 라모트리진 강화요법의 유용성을
평가한 자연경과연구이다. 전체 대상군에서 8주간 치료
후 유의한 우울증상의 호전이 관찰되었고, 반응군과 비
반응군 간 임상증상 변화양상은 3주 이후 유의하게 구분
되었다. 라모트리진 강화요법의 안전성도 관찰되었다. 라
모트리진 강화요법의 임상효능과 반응군의 특성을 밝히
기 위하여 대규모 전향적 통제연구가 필요하다.

영어초록

Objective：Lamotrigine’s possible efficacy in the treatment of depressive disorders has been suggested. This naturalistic
study investigated clinical response to lamotrigine augmentation in patients with treatment-resistant depression.
Characteristics of the lamotrigine-responders were also explored. Methods：Clinical data from 40 lamotrigine-
treated patients with treatment-resistant unipolar depression were analyzed. The subjects were diagnosed
with DSM-IV major depressive disorder and resistant to at least 2 antidepressants. Efficacy of lamotrigine treatment
was measured by the changes in mean scores of the Clinical Global Impression Severity subscale (CGI-S), which
were extracted from the prospective mood chart and structured interviews. Response was defined as a decrease of
at least 2 or more from baseline on the CGI-S. Untoward effects associated with lamotrigine treatment were also
assessed through medical records. Results：Significant reduction in the CGI-S mean score was observed from baseline
through 8 week lamotrigine augmentation in 40 patients with treatment-resistant unipolar depression (t=5.7,
df=39, p<.01), and the magnitude of treatment effect was large (reffect size=0.68). Drop-outs were mainly attributable
to lamotrigine-associated rash (N=5). Greater rate of improvement was associated with responder group
(N=14) compared to non-responder group (N=17) from week 3 onward. Conclusion：The results of current study
lend support to the potential benefit of lamotrigine augmentation in a subpopulation of patients with treatmentresistant
unipolar depression. Continuation of lamotrigine add-on for more than 3 weeks may be needed to assess
clinical outcome. Lamotrigine augmentation was generally well-tolerated. Large scale, double-blind studies are
necessary to confirm its use as an augmentation agent.

참고자료

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