Late Adverse Effects of the Coadministration of Valproate and Lamotrigine

Thomé‐Souza, Sigride; Moreira, Bernardo Pereira; Valente, Kette D.

doi:10.1016/j.pediatrneurol.2012.04.026

Cited by 20 publications

(11 citation statements)

References 13 publications

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“…The interaction between lamotrigine and valproate is well documented, and it is recommended that the two drugs not be combined( 4 , 5 , 7 , 8 ).Kavitha et al ( 5 ) reported on the case of a patient with painful ulcers in the mouth, bleeding lips, rashes throughout the body, and high fever (39°C) induced by a combination of lamotrigine and valproic acid (Stevens–Johnson syndrome).This is however not the case with sertraline which was prescribed to our patient. It is generally accepted that combined therapy of lamotrigine with sertraline should not increase the risk of toxic reactions to lamitrigine.…”

Section: Discussionmentioning

confidence: 99%

Adverse Effects of Antiepileptic Drug Lamotrigine and Oral Implications: Case Report

Malčić

Sivić

Matijević

2017

Acta Stomatol Croat

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Here, we report on a patient who presented with extensive oral lesions. The treatment with lamotrigine is described.The patient presented with bilateral facial swellings and mental space swelling with actively draining extra oral sinus tract in the central chin area. Dental medicine professionals should be aware of the risks involved with using this medication, and should recognize the population at risk among patients suffering from epilepsy, bipolar and neurologic disorders.

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Section: Discussionmentioning

confidence: 99%

Adverse Effects of Antiepileptic Drug Lamotrigine and Oral Implications: Case Report

Malčić

Sivić

Matijević

2017

Acta Stomatol Croat

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“…A recent report showed that in patients with bipolar disorder after 12-week of lamotrigine monotherapy the volume of the cerebellum decreased (Bauer et al 2018). Cerebellar signs and symptoms, like ataxia, nystagmus, vertigo, as LTG side-effects were also noted in epilepsy patients (Moreira et al 2007;Thome-Souza et al 2012). These findings raise the possibility that lamotrigine-induced tremor might be a result of cerebellar dysfunction.…”

Section: Introductionmentioning

confidence: 92%

Lamotrigine Induces Tremor among Epilepsy Patients Probably via Cerebellar Pathways

Kovács

Farkas

Kelemen

et al. 2019

Tohoku J. Exp. Med.

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Lamotrigine, a frequently used antiepileptic drug, inhibits voltage-gated sodium-channels. By suppressing the release of glutamate and aspartate, lamotrigine acts as a membrane stabilizer, and it is also effective in bipolar disorder and migraine. However, lamotrigine is known to induce tremor among 4-10% of patients. We examined the lamotrigine-induced tremor in 28 epilepsy patients (age: 38.06 ± 13.56 years; 24 females and 4 males) receiving lamotrigine monotherapy and compared the data to 30 age-and sex-matched controls (age: 33.06 ± 10.71 years; 25 females and 5 males). Tremor was visually assessed by clinical tremor rating scales. Quantitative characteristics (intensity, center frequency and frequency dispersion) which are regularly used to differentiate various tremor syndromes were measured by validated, sensitive biaxial accelerometry in resting, postural and intentional positions. Regularity of repetitive finger and hand movements and reaction time were also determined. Data were statistically analyzed. Clinical tremor rating scales detected pathological tremor in three patients (10%), while accelerometry revealed tremor in seven patients (25%). Center frequency of patients with pathological tremor was similar to controls, but the frequency dispersion was significantly lower and tremor intensity was significantly higher in both postural and intentional positions. Rhythmic movements and reaction time were normal. Our results show that objective measurements detect pathological intention tremor in 25% of epilepsy patients receiving lamotrigine monotherapy. Quantitative characteristics suggest the involvement of the cerebellum in the pathomechanism of lamotrigine-induced tremor. Determining the parameters of drug-induced tremor syndromes might help to understand the complex action of tremor generator networks.

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“…Two cases reported had possible drug interactions, so a clear association can only be suspected. The drugs interacting with VPA were ziprasidone and lamotrigine; VPA can increase the levels of ziprasidone/lamotrigine by decreasing their metabolism (Alonso-Navarro et al, 2007;Thome-Souza et al, 2012). The VPA-dose decrease was enough for the achievement of a full recovery in the reports.…”

Section: Stutter Tic and Akathisia (Akt)mentioning

confidence: 99%

Valproate-associated Movement Disorder: A Literature Review

2021

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Valproate (VPA) was first synthesized in 1882, but it was only in the early 1960s that its anticonvulsant properties were discovered. The aim of this literature review is to evaluate the clinical epidemiological profile, pathological mechanisms, and management of VPA-associated movement disorder (MD). Relevant reports in six databases were identified and assessed by two reviewers without language restriction. A total of 138 reports containing 362 cases of subjects who developed a MD secondary to VPA were reported. The MD identified were parkinsonism (PKN) (252), myoclonus (MCL) (54), dystonia (DTN) (17), dyskinesia (DKN) (16), stutters (4), tics (3), akathisia (AKT) (1). In the not clearly defined group, 15 extrapyramidal symptoms, 3 AKT, 2 DTN, 1 rigidity, 1 unstable gait were assessed. The mean and median age was 55.8 (SD: 16.58) and 61 years (range: 4–87 years). The most common VPA-indication was epilepsy, and 51.36% were males. The mean and median time from the VPA start to the MD onset was 32.75 (SD: 30.05) and 21.15 months (range: 1 day – 20 years). The mean and median time from the VPA withdrawal until the MD recovery was 2.89 (SD: 2.79) and 3 months (1 day – 12 months). The most common management was drug withdrawal. A complete recovery was obtained in 80.61%. VPA-associated MD was extensively reported in the literature. PKN was the most well-described. Future studies need to clearly report the clinical history of the patient, considering the full investigation of other adverse events during their entire life.

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Late Adverse Effects of the Coadministration of Valproate and Lamotrigine

Cited by 20 publications

References 13 publications

Adverse Effects of Antiepileptic Drug Lamotrigine and Oral Implications: Case Report

Adverse Effects of Antiepileptic Drug Lamotrigine and Oral Implications: Case Report

Lamotrigine Induces Tremor among Epilepsy Patients Probably via Cerebellar Pathways

Valproate-associated Movement Disorder: A Literature Review

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