March 18 2017 by Ray Sahelian, M.D.
Lamotrigine is an anticonvulsant medicine that is chemically unrelated to any other anticonvulsant or mood regulating medication. Lamotrigine was approved in 1994 and was labeled for use as an anticonvulsant. In 2003 it was approved by the FDA for use as a treatment for people with bipolar disorder. There is no generic lamotrigine in the USA as the manufacturer has patent protection. Generic lamotrigine is available in Canada.
Neuropsychopharmacol Hung. 2015. Treatment of bipolar disorder with lamotrigine -- relapse rate and suicidal behaviour during 6 month follow-up. The present paper describes a 8-month prospective, observational, non-intervention multicentric study in 969 bipolar patients, where data were obtained on changes during lamotrigine treatment with special focus rates of relapse, suicidal behaviour and adverse events. 969 patients entered the study and 961 patients (99%) completed the study. Patients received lamotrigine mostly as an add-on treatment in addition to ongoing antidepressant and/or antipsychotic medication. By the end of the six-month treatment period 38% of patients achieved remission and rate of relapse after three months was 24%. Rate of adverse events was very low (1%) and they in no case led o termination of therapy. At baseline 17% of patients had clinically significant suicide risk which gradually decreased to 2.1% during the 6-month study period. No suicide attempt or completed suicide occurred during the study period.
Lamotrigine and Depression
Lamotrigine is sometimes used in patients who have failed to respond to antidepressants or mood stabilizers. Patients with hard-to-treat bipolar syndromes and with schizoaffective disorder have been treated more often than patients with "treatment-resistant" unipolar disorders. Some people with such hard to treat unipolar depressions have been treated with good results. Some patients diagnosed with Borderline Personality Disorder, a disorder that many psychiatrists believe is a variant of Bipolar Disorder, have responded to treatment with lamotrigine. Patients with Post-Traumatic Stress Disorder and with Depersonalization Disorder have also responded well to lamotrigine therapy.
J Clinical Psychiatry.
2013. Lamotrigine in psychiatric disorders. Lamotrigine is recommended in
bipolar maintenance when depression is prominent. It also has a role in treating
acute bipolar depression and unipolar depression, though the latter warrants
more research. Data are too limited in other psychiatric disorders to recommend
its use at this time.
Lamotrigine side effects, danger, risk, concerns
Lamotrigine side effects include: Dizziness, headache, double vision or blurred vision, unsteadiness, nausea and vomiting, sleepiness and rash.
Lamotrigine and Cleft Palate
GlaxoSmithKline warned in 2006 that there is an increased risk of cleft lip or cleft palate when the company's antiepileptic drug lamotrigine is used during early pregnancy. GlaxoSmithKline said cleft palate deformity was detected at "an elevated rate" in infants whose mothers used the lamotrigine treatment during the first three months of pregnancy, compared with those who weren't exposed to the drug. Antiepileptic drugs have been associated with oral clefts, while other factors including smoking, heavy alcohol intake, various infections, folic acid deficiency, and vitamin A intoxication, have also contributed. Oral clefts occur 0.5 to 2.16 times per 1,000 births. GlaxoSmithKline advised patients who are being treated with lamotrigine and who are, or intend to become pregnant, to discuss treatment with their doctors.