TABLE 4.

Randomized Trials of mono- versus dual pharmacotherapies for acute bipolar depression

Intervention	Duration	Outcome	Adverse effects
Lamotrigine (N=64) or placebo (N=60) plus lithium (77)	8 weeks	Adjunctive lamotrigine (200 mg/day) was more effective than placebo	None greater with adjunctive lamotrigine than with lithium monotherapy
Lamotrigine (N=101) or placebo (N=101) plus quetiapine (78)	12 weeks	Adjunctive lamotrigine (200 mg/day) > placebo	None greater with adjunctive lamotrigine than with placebo
Lurasidone (N=183) or placebo (N=165) plus lithium or divalproex (79)	6 weeks	Adjunctive lurasidone (mean dose 66.3 mg/day) was more effective than placebo	Greater nausea, somnolence, tremor, akathisia, and insomnia with adjunctive lurasidone than with placebo
Ziprasidone (N=147) or placebo (N=147) plus lithium or divalproex or lamotrigine (80)	6 weeks	Adjunctive ziprasidone (mean dose=89.8 mg/day) no different from placebo	More nausea, fatigue, dizziness, sedation, somnolence with adjunctive ziprasidone than with placebo