Beyond Epilepsy: Potential clinical applications of Lamotrigine in
Neurology and Psychiatry
Authors: Robert Leadbetter, Theodore Spaulding, Gary Evoniuk, John Messenheimer
Affiliations: GlaxoSmithKline, Research Triangle Park, North Carolina, USA
Correspondence and requests for reprints should be addressed to:
Dr Robert Leadbetter
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Abstract
Objective:
Given the fundamental role of glutamate in diverse aspects of brain function and pathology, medications that affect glutamatergic transmission potentially have broad applications in neurology and psychiatry. This paper reviews data on various neuropsychiatric applications of lamotrigine in disorders hypothesized to involve glutamatergic dysfunction.
Methods:
Data for review were identified via Medline searches employing no date restrictions and using as key words “lamotrigine” and terms for each of the relevant neurologic and psychiatric conditions considered in this paper.
Results:
Lamotrigine shows evidence of efficacy in several neuropsychiatric conditions in addition to its marketed uses for the treatment of epilepsy and bipolar disorder.
Conclusions:
Considered in aggregate, the data suggest that lamotrigine improves attention, mood, cognition, and behavior in range of neurologic and psychiatric disorders including: schizophrenia, Alzheimer’s disease, and treatment-refractory unipolar depression. However, with the exception of the data in bipolar disorder and some of the research in schizophrenia and Alzheimer’s disease, many of the findings come from case series or open-label studies and warrant confirmation in larger, placebo-controlled studies. As most of the neuropsychiatric disorders for which lamotrigine appears effective involve dysfunction of multiple neurotransmitter systems, combination therapy with medications affecting multiple neurotransmitter systems may be necessary to optimize treatment outcomes.
Key Words: lamotrigine, mental illness, depression, bipolar disorder, schizophrenia,
developmental disorders, dementia
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