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Lamictal Brief Information
- Active ingredient: Lamotrigine
- Brand names: Lamictal
- Drug class: Anticonvulsant
- Company Name: GlaxoSmithKline
- Pregnancy Category: C
- Dosages: 25 mg, 100 mg, 150 mg, 200 mg tablets, 2 mg,
5 mg, 25 mg chewable dispersible tablets
- FDA approved: 27 December 1994 (as an anticonvulsant),
2003 (for bipolar disorder)
- Habit forming? No
- Avalable as generic? No
- Lamictal
side effects, dosage, uses
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Lamictal Detailed Information
Lamotrigine (brand name Lamictal), is an anticonvulsant drug,
used in epilepsy and bipolar disorder.
Epilepsy Adjunctive Use: Lamictal is indicated as adjunctive
therapy for partial seizures, the generalized seizures of Lennox-Gastaut
syndrome, and primary generalized tonic-clonic seizures in adults
and pediatric children of 2 years of age and older.
Epilepsy Monotherapy Use: Lamictal is indicated for conversion
to monotherapy in adults with partial seizures who are receiving
treatment with carbamazepine, phenytoin, phenobarbital, primidone,
or valproate as the single AED.
Bipolar Disorder: Lamictal is indicated for the maintenance
treatment of Bipolar I Disorder to delay the time to occurrence
of mood episodes (depression, mania, hypomania, mixed episodes)
in patients treated for acute mood episodes with standard therapy.
The effectiveness of Lamictal in the acute treatment of mood episodes
has not been established.
Lamictal is chemically unrelated to existing antiepileptic drugs;
precise mechanisms of action are unknown. One proposed mechanism
suggests inhibition of voltage-sensitive sodium channels, thereby
stabilizing neuronal membranes that modulate presynaptic transmitter
release of excitatory amino acids (eg, glutamate, aspartate).
Lamictal Off-label & Under consideration Uses
- Other forms of bipolar disorder
- Depression 1
- Schizoaffective disorder
- SUNCT syndrome headaches 3
- Neuralgia after nerve section 2
- Diabetic neuropathy 4
- Weight loss 7
Lamictal Advantages:
- Medication is usually well tolerated
- Causes little cognitive impairment (effect on the ability to
think) or overt sedation compared with other treatments
- Not associated with weight gain 5
- Improvement in sexual dysfunction 8
- May help with weight loss 6,
7
- Minimal sedation
- Works for all types of seizures
Lamictal Disadvantages:
- Risk of serious rash such as Stevens–Johnson syndrome 9
- The need for slow titration
- Potential for drug interactions
Lamictal for Epilepsy
The results of controlled clinical trials established the efficacy
of Lamictal as monotherapy in adults with partial onset seizures
already receiving treatment with carbamazepine, phenytoin, phenobarbital,
or primidone as the single antiepileptic drug (AED), as adjunctive
therapy in adults and pediatric patients age 2 to 16 with partial
seizures, and as adjunctive therapy in the generalized seizures
of Lennox-Gastaut syndrome in pediatric and adult patients.
Lamictal for Bipolar Disorder
The effectiveness of Lamictal in the maintenance treatment of Bipolar
I Disorder was established in 2 multicenter, double-blind, placebo-controlled
studies in adult patients who met DSM-IV criteria for Bipolar I
Disorder. Study 1 enrolled patients with a current or recent (within
60 days) depressive episode as defined by DSM-IV and Study 2 included
patients with a current or recent (within 60 days) episode of mania
or hypomania as defined by DSM-IV. Both studies included a cohort
of patients (30% of 404 patients in Study 1 and 28% of 171 patients
in Study 2) with rapid cycling Bipolar Disorder (4 to 6 episodes
per year).
Although these studies were not designed to separately evaluate
time to the occurrence of depression or mania, a combined analysis
for the 2 studies revealed a statistically significant benefit for
Lamictal over placebo in delaying the time to occurrence of both
depression and mania, although the finding was more robust for depression.
References
- 1. Gutierrez RL, McKercher RM, Galea J, Jamison
KL. Lamotrigine augmentation strategy for patients with treatment-resistant
depression. CNS Spectr. 2005 Oct;10(10):800-5. PubMed
- 2. Sandner-Kiesling A, Rumpold Seitlinger
G, Dorn C, Koch H, Schwarz G. Lamotrigine monotherapy for control
of neuralgia after nerve section. Acta Anaesthesiol Scand. 2002
Nov;46(10):1261-4. PubMed
- 3. Gutierrez-Garcia JM. SUNCT syndrome responsive
to lamotrigine. Headache. 2002 Sep;42(8):823-5. PubMed
- 4. Vinik AI, Tuchman M, Safirstein B, Corder
C, Kirby L, Wilks K, Quessy S, Blum D, Grainger J, White J, Silver
M. Lamotrigine for treatment of pain associated with diabetic
neuropathy: results of two randomized, double-blind, placebo-controlled
studies. Pain. 2007 Mar;128(1-2):169-79. Epub 2006 Dec 11. PubMed
- 5. Brown EB, McElroy SL, Keck PE Jr, Deldar
A, Adams DH, Tohen M, Williamson DJ. A 7-week, randomized, double-blind
trial of olanzapine/fluoxetine combination versus lamotrigine
in the treatment of bipolar I depression. J Clin Psychiatry. 2006
Jul;67(7):1025-33. PubMed
- 6. Bowden CL, Calabrese JR, Ketter TA, Sachs
GS, White RL, Thompson TR. Impact of lamotrigine and lithium on
weight in obese and nonobese patients with bipolar I disorder.
Am J Psychiatry. 2006 Jul;163(7):1199-201. PubMed
- 7. Merideth CH. A single-center, double-blind,
placebo-controlled evaluation of lamotrigine in the treatment
of obesity in adults. J Clin Psychiatry. 2006 Feb;67(2):258-62.
PubMed
- 8. Gil-Nagel A, Lo'pez-Mun~oz F, Serratosa
JM, Moncada I, Garci'a-Garci'a P, Alamo C. Effect of lamotrigine
on sexual function in patients with epilepsy. Seizure. 2006 Apr;15(3):142-9.
Epub 2006 Jan 24. PubMed
- 9. Hilas O, Charneski L. Lamotrigine-induced
Stevens-Johnson syndrome. Am J Health Syst Pharm. 2007 Feb 1;64(3):273-5.
PubMed
Interesting
Lamictal facts
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