A pooled analysis of 2 placebo-controlled 18-month trials of lamotrigine and lithium maintenance in bipolar I disorder
If my episodes tend to be depressive rather than manic, does that make lamotrigine a better long-term fit for me than lithium?
Reasonable evidence with real limitations. how we score evidence
Caveat on this rating: Funding statement is behind a paywall and could not be read; the two component maintenance trials are widely reported as manufacturer-sponsored, so weigh sponsorship accordingly.
In 638 patients randomized after stabilization, lamotrigine roughly doubled the time to the next mood episode versus placebo (median 197 vs 86 days), working mainly against depressive relapse while lithium worked mainly against mania.
Worth asking
If my episodes tend to be depressive rather than manic, does that make lamotrigine a better long-term fit for me than lithium?
What it is FDA approved for
Read off the label. Trial duration and approval year are shown only where they were recorded — never inferred.
- Maintenance treatment of bipolar I disorder (to delay time to occurrence of mood episodes, after acute stabilization)
- Epilepsy, adjunctive therapy (partial-onset seizures, primary generalized tonic-clonic seizures, Lennox-Gastaut syndrome; ages 2+)
- Epilepsy, conversion to monotherapy for partial-onset seizures (ages 16+)
Source
A pooled analysis of 2 placebo-controlled 18-month trials of lamotrigine and lithium maintenance in bipolar I disorder — Goodwin GM, et al. (2004)
Reputable peer-reviewed journal
Read the source: https://doi.org/10.4088/jcp.v65n0321
DOI: 10.4088/jcp.v65n0321
How this was scored
- Study design
- Meta-analysis of randomised trials
- Funding
- Funding not disclosed
- Published in
- Reputable peer-reviewed journal
- Sample size
- 638
- Preregistered
- No
- Conflicts disclosed
- No
- Independent of proponent
- not recorded
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published August 19, 2026.
Where we put this study in context
Questions
How strong is the evidence behind this?
Resolv rates this source "moderate evidence". Reasonable evidence with real limitations. It scores 66 out of 100 on our published rubric. One caveat travels with that badge: Funding statement is behind a paywall and could not be read; the two component maintenance trials are widely reported as manufacturer-sponsored, so weigh sponsorship accordingly. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
A pooled analysis of 2 placebo-controlled 18-month trials of lamotrigine and lithium maintenance in bipolar I disorder — Goodwin GM, et al. (2004). Published in: Reputable peer-reviewed journal. DOI: 10.4088/jcp.v65n0321. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Meta-analysis of randomised trials. Funding: Funding not disclosed. Independence from the proponent is not recorded. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is lamotrigine (Lamictal), lamictal FDA approved?
Yes — FDA approved for Maintenance treatment of bipolar I disorder (to delay time to occurrence of mood episodes, after acute stabilization), Epilepsy, adjunctive therapy (partial-onset seizures, primary generalized tonic-clonic seizures, Lennox-Gastaut syndrome; ages 2+), Epilepsy, conversion to monotherapy for partial-onset seizures (ages 16+). Approval is for a specific indication, not for everything the drug is prescribed for.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.