Understanding Lamotrigine’s Role in the CNS and Possible Future Evolution

Abstract

The anti-epileptic drug lamotrigine (LTG) has been widely used to treat various neurological disorders, including epilepsy and bipolar disorder. However, its precise mechanism of action in the central nervous system (CNS) still needs to be determined. Recent studies have highlighted the involvement of LTG in modulating the activity of voltage-gated ion channels, particularly those related to the inhibition of neuronal excitability. Additionally, LTG has been found to have neuroprotective effects, potentially through the inhibition of glutamate release and the enhancement of GABAergic neurotransmission. LTG’s unique mechanism of action compared to other anti-epileptic drugs has led to the investigation of its use in treating other CNS disorders, such as neuropathic pain, PTSD, and major depressive disorder. Furthermore, the drug has been combined with other anti-epileptic drugs and mood stabilizers, which may enhance its therapeutic effects. In conclusion, LTG’s potential to modulate multiple neurotransmitters and ion channels in the CNS makes it a promising drug for treating various neurological disorders. As our understanding of its mechanism of action in the CNS continues to evolve, the potential for the drug to be used in new indications will also be explored.

Is the regulation of lamotrigine on depression in patients with epilepsy related to cytokines?

“…Pro-inflammatory cytokines can cause a breakdown of the blood-brain barrier, enter the brain, activate glial cells, and lead to inflammatory storm, which leads to the increase of peripheral blood cytokine levels. There is evidence that LTG can repair the blood-brain barrier damage caused by central nervous system diseases, thus interrupting this positive feedback pathway and reducing the level of cytokines [ 39 ].…”

Antiepileptogenic Effects of Anakinra, Lamotrigine and Their Combination in a Lithium–Pilocarpine Model of Temporal Lobe Epilepsy in Rats

“…Lamotrigine, an anticonvulsant drug, is commonly prescribed for managing epilepsy. Its efficacy is linked to its ability to block voltage-gated sodium channels, which reduces abnormal electrical activity in the brain [26]. More recently, evidence indicates that lamotrigine has antiepileptogenic properties.…”

Influence of Long-Term Anti-Seizure Medications on Redox Parameters in Human Blood

“…Although they are chemically different, they all prevent seizures. However, many anti-seizure medications are metabolised to produce reactive metabolites that can bind macromolecules and thus both impair function on a molecular level and elicit systemic toxicity [ 15 ]. The role of anti-seizure medications in oxidative/antioxidative processes is controversial [ 4 ] and ranges from a moderate antioxidant to a prooxidant effect.…”