Lamotrigine in the treatment of psychiatric disorders

Background. Bipolar and other mood disorders often do not respond satisfactorily to lithium, valproate, carbamazepine or antidepressants. Material and methods. On the basis of six years of clinical experience with lamotrigine in the treatment of psychiatric disorders, supplemented by three case reports and a comprehensive literature review of empirical studies, we discuss the possible indications for lamotrigine in psychiatric disorders. Results. Lamotrigine seems to have a stronger antidepressant effect in bipolar 1 disorders than gabapentine. carbamazepine and valproate, but a weaker effect on manic symptomatology than the latter two. Lamotrigine may be of value in the treatment of bipolar 2 disorders in which chronic treatment resistant depression is often a complication. including rapid cycling and, in the unipolar version of rapid cycling, brief recurrent depression. We have also used to good effect the neuroprotective effects of lamotrigine in prophylactic treatment of neurodegenerative disorders le.g. Huntington's chorea). Interpretation. Lamotrigine is an anticonvulsant with an efficacy profile in psychiatric disorders different From those of valproate. carbamazepine and gabapentine. The drug represents an important supplement to the treatment options in chronic recurrent mood and neuropsychiatric disorders.