Lamotrigine

Goldsmith, David R.; Wagstaff, Antona J.; Ibbotson, Tim; Perry, Caroline M.

doi:10.2165/00003495-200363190-00009

Cited by 157 publications

(37 citation statements)

References 66 publications

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“…Antidepressant efficacy has not been demonstrated for standard antidepressants or typical antipsychotics, either as acute treatments for bipolar depression, or as maintenance therapy for the prevention of depression relapse 4, 5, 6, 7, 8. There is weak evidence for the maintenance efficacy of most mood stabilizers in the prevention of depressive relapse (notably lithium, valproate, carbamazepine),9 and stronger evidence suggesting that lamotrigine may be effective in delaying depressive episode recurrence 10…”

Section: Introductionmentioning

confidence: 99%

Lurasidone in the Long‐term Treatment of Patients With Bipolar Disorder: A 24‐week Open‐label Extension Study

et al. 2016

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BackgroundThe aim of this study was to evaluate the safety and tolerability of 6 months of open‐label, uncontrolled extension treatment with lurasidone in patients with a diagnosis of bipolar depression who completed 6 weeks of acute treatment.MethodsPatients completing 6 weeks of double‐blind placebo‐controlled treatment with either lurasidone monotherapy (one study) or adjunctive therapy with lithium or valproate (two studies), were treated for 6 months with flexible doses of lurasidone, 20–120 mg/day, in an open‐label, uncontrolled extension study (N = 813; monotherapy, 38.9%; adjunctive therapy, 61.1%). Changes in safety parameters were calculated from double‐blind, acute‐phase baseline to month 6 of the extension phase, using a last observation carried forward (LOCF endpoint) analysis.ResultsFive hundred fifty‐nine of 817 (68.4%) patients completed the extension study. In the monotherapy and adjunctive therapy groups, 6.9 and 9.0%, respectively, discontinued due to an adverse event. For the monotherapy and adjunctive therapy groups, respectively, changes from double‐blind baseline to month 6 were +0.8 and +0.9 kg for weight (mean), 0.0 and +2.0 mg/dL for total cholesterol (median), +5.0 and +5.0 mg/dL for triglycerides (median), −1.0 and 0.0 mg/dL for glucose (median); −22.6 and −21.7 for Montgomery‐Asberg Depression Rating Scale (MADRS; mean); whereas change from open‐label baseline to month 6 were +0.85 and +0.88 kg for weight (mean), and −6.9 and −6.5 for MADRS (mean).ConclusionsSix months of treatment with open‐label lurasidone was safe and well tolerated with minimal effect on weight and metabolic parameters; continued improvement in depressive symptoms was observed.

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Section: Introductionmentioning

confidence: 99%

Lurasidone in the Long‐term Treatment of Patients With Bipolar Disorder: A 24‐week Open‐label Extension Study

et al. 2016

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“…14 At present there is no evidence that lamotrigine destabilises mood when used to treat acute mood episodes or as maintenance, so it can be introduced from the beginning of a depressive episode.…”

Section: Side-effectsmentioning

confidence: 99%

Lamotrigine to prevent depressive episodes in bipolar disorder

Saunders¹,

Goodwin²

2011

Prescriber

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“…While the half-life of lamotrigine is around 22 hours in drug naïve patients, indicating that once-a-day dosing would be feasible, the metabolism may be induced or inhibited [16]. The half-life of lamotrigine in patients taking enzyme inducers is around 12 hours [21]. The clearance of lamotrigine is significantly reduced in patients taking valproic acid, due to inhibition of lamotrigine’s glucuronidation by valproate [51].…”

Section: Clinical Pharmacology Of Aedsmentioning

confidence: 99%

Transitional Polytherapy: Tricks of the Trade for Monotherapy to Monotherapy AED Conversions

Garnett

Louis

Henry

et al. 2009

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The goal of epilepsy therapy is to help patients achieve seizure freedom without adverse effects. While monotherapy is preferable in epilepsy treatment, many patients fail a first drug due to lack of efficacy or failure to tolerate an initial medication, necessitating an alteration in therapy. Sudden changes between monotherapies are rarely feasible and sometimes deleterious given potential hazards of acute seizure exacerbation or intolerable adverse effects. The preferred method for converting between monotherapies is transitional polytherapy, a process involving initiation of a new antiepileptic drug (AED) and adjusting it toward a target dose while maintaining or reducing the dose of the baseline medication. A fixed-dose titration strategy of maintaining the baseline drug dose while titrating the new medication is preferable when breakthrough seizures are occurring and no adverse effects are present. However, a flexible titration strategy involving reduction of the baseline drug dose to ensure adequate tolerability of the new adjunctive medication is preferred when patients are already experiencing adverse effects. This article reviews pharmacokinetic considerations pertinent for ensuring successful transitional polytherapy with the standard and newer antiepileptic drugs. Practical consensus recommendations “from an expect panel (SPECTRA, Study by a Panel of Experts Considerations for Therapy Replacement and Antiepileptics) for a successful monotherapy” AED conversions are then summarized. Transitional polytherapy is most successful when clinicians appropriately manage the titration strategy and consider pharmacokinetic factors germane to the baseline and new adjunctive medication.

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Lamotrigine

Cited by 157 publications

References 66 publications

Lurasidone in the Long‐term Treatment of Patients With Bipolar Disorder: A 24‐week Open‐label Extension Study

Lurasidone in the Long‐term Treatment of Patients With Bipolar Disorder: A 24‐week Open‐label Extension Study

Lamotrigine to prevent depressive episodes in bipolar disorder

Transitional Polytherapy: Tricks of the Trade for Monotherapy to Monotherapy AED Conversions

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