A Comparative Study Of Duloxetine Combined With Lamotrigine In The Treatment Of Patients With Treatment-resistant Depression

Objective To investigate the efficacy and safety of duloxetine combined with lamotrigine in the treatment of patients with treatment-resistant depression.(TRD)And provide some theoretical guidance and basis for clinical treatment.Methods This study participants included 88 patients with treatment-resistant depression as the research object,from October 2013 to March 2016 in xinwen mining group laiwu center hospital psychiatric patients.Inclusion criteria:(1)in accordance with the diagnostic and Statistical Manual of mental disorders Fourth Edition(DSM-IV)in diagnostic criteria for major depressive disorder;(2)Hamilton Depression Scale(Hamilton Depression Scale,HAMD)17 version,total score more than 17 points;(3)through at least 2 different mechanisms of action antidepressant enough(enough refers to more than the maximum recommended dose of 2/3 can reach the maximum amount of treatment,when necessary,concentration)and schedule system(treatment of each drug treatment was longer than 6weeks),invalid or ineffective;(4)aged 18 to 65 years;(5)patients or their families the study of informed consent and signed informed consent;(6)exclusion criteria:(1)Patients with bipolar disorder,mental disorders,mental retardation,any other form;(2)in the depression before the existence of psychoactive substances in Lai or abusers(DSM-IV standard);(3)both have serious physical disease and nervous system disease;(4)the pregnant and lactating women;(5)People who have difficulty communicating;(6)Uncooperative.Patients were randomly divided into 2 groups by random number method.The study group of 46 patients,including 13 cases of male,female 33 cases,average age(45.25 + 13.37)years old,the average duration of(18.51 + 8.31)years,treatment methods: duloxetine and lamotrigine treatment;42 cases of control group patients,there were 12 males and 30 females.The average age was(49.36 + 12.73)years old,the average duration of(19.1 + 9.78)years,treatment methods are: Taking duloxetine treatment,two groups of treatment was 8 weeks.The two groups of patients were assessed with Hamilton Depression Scale(HAMD),Clinical Global Impression scale(CGI)and Treatment Emergent Symptom Scale(TESS)at baseline,and at the 2nd,4th,6th and 8th weekend of treatment.Results the study group and control group in age,sex,disease severity and duration of difference were not significant(P > 0.05).The scores of Hamilton Depression Scale(HAMD) and Clinical Global Impression scale(CGI)in two groups at the 2nd,4th,6th and 8th weekend of treatment were all significantly lower than those at baseline(p ? 0.05).At the 2nd weekend of treatment,the scores of HAMD and CGI in study group were all significantly lower than those in control group(p ? 0.05),Especially in the depression and the improvement of the two aspects of work and interest.At the 8th weekend,there were no differences for the effective rates and side effects rates between two groups(P > 0.05).Conclusion duloxetine combined with lamotrigine in the treatment of refractory depression and single duloxetine although the overall effect was no significant difference,but the onset time of fast,can quickly relieve refractory depressive symptoms,and well tolerated,which can increase the confidence in the treatment and the treatment compliance of patients,it is worth using in clinical application...