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OBJECTIVES: Although not licensed for acute bipolar depression, lamotrigine has evidence for efficacy in trials and its use is recommended in guidelines. So far there had been no prospective health economic evaluation of its use. METHODS: Cost-utility analysis of the CEQUEL trial comparing quetiapine plus lamotrigine vs quetiapine monotherapy (and folic acid vs placebo in an add-on factorial design) for patients with bipolar depression (n = 201) from the health and social care perspective. Differences in costs together with quality-adjusted life years (QALYs) between the groups were assessed over 52 weeks using a regression-based approach. RESULTS: Health-related quality of life improved substantially for all randomization groups during follow-up with no significant difference in QALYs between any of the comparisons (mean adjusted QALY difference: lamotrigine vs placebo -0.001 (95% CI: -0.05 to 0.05), folic acid vs placebo 0.002 (95% CI: -0.05 to 0.05)). While medication costs in the lamotrigine group were higher than in the placebo group (£647, P 

Original publication




Journal article


Bipolar Disord

Publication Date





733 - 745


bipolar disorder, cost, cost-effectiveness, cost-utility, depression, economic evaluation, quality of life, Antipsychotic Agents, Bipolar Disorder, Cost-Benefit Analysis, Depression, Double-Blind Method, Drug Therapy, Combination, Female, Folic Acid, Humans, Lamotrigine, Male, Placebos, Quality of Life, Quality-Adjusted Life Years, Quetiapine Fumarate, Treatment Outcome