Lamotrigine Treatment of Refractory Bipolar Disorder

Abstract

Lamotrigine Treatment of Refractory Bipolar DisorderSir: Lamotrigine represents a new class of anticonvulsant for the treatment of adult patients with refractory partial seizures. Lamotrigine is chemically unrelated to carbamazepine and phenytoin, but is thought to act at voltage-sensitive sodium channels to stabilize neuronal membranes and inhibit transmitter release, principally glutamate and aspartate, 1 similar to the inhibition of neuronal activity produced by phenytoin and carbamazepine.2 Further, lamotrigine has been shown to possess efficacy similar to that of carbamazepine in control of onset of partial seizures and primary generalized tonic-clonic seizures.

Depression in Epilepsy: A Common but Often Unrecognized Comorbid Malady

“…CBZ, commonly used in the treatment of both partial and generalized epilepsies, is now also frequently used in psychiatry for the treatment of aggressive behavior and bipolar disease (71,99,101). Several recent papers have described mood-stabilizing properties of LTG in patients with treatment-refractory bipolar disease (102)(103)(104). These effects have recently been confirmed in randomized, controlled studies.…”

Lamotrigine in the Treatment of Schizoaffective Disorder

“…In particular, lamotrigine might disorder, having 6 schizomanic episodes since age 21, with full remission in between. Originally, the disorder started with a severe depresbe helpful in treatment-refractory bipolar disorder [4][5][6], sion and a suicide attempt in 1986. The patient continuously took rapid-cycling bipolar disorder [7,8], bipolar depression lithium since 1993, the last schizomanic episodes were 3/97 and 9/97.…”

An open longitudinal study of patients with bipolar rapid cycling treated with lithium or lamotrigine for mood stabilization

“…Several investigations have suggested that the new antiepileptic drug lamotrigine is efficacious in bipolar disorder, particularly in rapid cycling [10–14] and bipolar depression [15]. A randomized, placebo controlled double blind study indicated a good antidepressant effect of 50 and 200 mg of lamotrigine in patients with bipolar depression [15].…”