Lamotrigine (Lamictal IR) for the treatment of bipolar disorder

Charles L. Bowden, Vivek Singh

Research output: Contribution to journalReview article

14 Scopus citations

Abstract

Introduction: Over the past decade the use of lamotrigine in bipolar disorder has increased. However, the evidence base suggests a more limited role for lamotrigine as part of an overall treatment regimen in bipolar disorder. Areas covered: We reviewed publications of randomized clinical trials of lamotrigine, emphasizing studies in bipolar disorder. The low burden of adverse effects with lamotrigine has been confirmed in these studies. Its lack of benefit in acute mania is established. Despite modest benefits for a subset of depressive episodes in bipolar disorder, it was not superior to placebo in well-designed studies. As monotherapy, in randomized, blinded trials in rapid cycling bipolar disorder it was not superior to placebo. Its role in maintenance treatment is relatively well established as one component of combination therapy, with evidence for benefits when combined with lithium or valproate. Combination regimens including lamotrigine appear to be superior to monotherapy. Monotherapy utilization of lamotrigine for maintenance treatment is not supported by these studies. Expert opinion: Lamotrigine has benefits in bipolar disorder management principally as a component of combination treatment which includes a mood stabilizer. The utility of lamotrigine in acute bipolar depression and major depressive disorder is modest.

Original languageEnglish (US)
Pages (from-to)2565-2571
Number of pages7
JournalExpert Opinion on Pharmacotherapy
Volume13
Issue number17
DOIs
StatePublished - Dec 1 2012

Keywords

  • Bipolar
  • Depression
  • Lamotrigine
  • Mania
  • Treatment

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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