Authors: Goldsmith DR, et al.
Title: Lamotrigine, a review of its use in bipolar disorder.
Reference: Drugs 2003;63:2029-50.
Purpose: To review studies in patients with bipolar disorder who received lamotrigine.
Study design: Retrospective analysis of published and unpublished trials from 1980 to 2003. Preference for randomized, double-blinded, placebo-controlled trials.
Follow up: Not applicable.
Patients: 2,272 patients with bipolar disorder.
Treatment: In most studies lamotrigine was titrated to 200 mg/day over 5–6 weeks, in some it was titrated to 400 mg/day or 500 mg/day.
Results: Lamotrigine is an effective maintenance therapy for bipolar disorder, significantly delaying time to intervention for any emerging mood episode. It is especially effective for a depressive episode, with limited efficacy in preventing manic or hypomanic mood episodes. Therapy should be considered during or shortly after stabilization of an acute mood episode before new depressive or manic symptoms occur. The efficacy of lamotrigine has been shown in the treatment of patients with an existing depressive episode but not manic episode. Generally, lamotrigine was well tolerated, with no gain in body weight and no serum monitoring required.