Positive and negative psychotropic effects of lamotrigine in patients with epilepsy and mental retardation.
OBJECTIVE
To describe significant positive or negative psychotropic effects of lamotrigine (LTG) observed in epilepsy patients with mental retardation (MR).


METHODS
Seven mentally retarded epilepsy patients, [5 with Lennox-Gastaut syndrome (LGS)] who experienced significant behavioral improvements or worsening after addition of LTG to their medication regimen were studied.


RESULTS
LTG produced behavioral improvements in 4 patients. Patient 1, a 14-year-old girl, had LTG added to valproate (VPA) and thioridazine, resulting in diminished lethargy, less hyperactivity, and more appropriate speech. In a 17-year-old boy (patient 2) LTG added to VPA, phenytoin (PHT), and gabapentin (GBP) lessened irritability and hyperactivity. In patient 3, a 41-year-old woman, LTG added to PHT, VPA, and carbamazepine (CBZ) diminished lethargy and enhanced her social interactions. In patient 4, a 27-year-old man, LTG monotherapy diminished irritability and hyperactivity. Adverse behavioral effects were noted in 3 patients. In patient 5, a 43-year-old man, LTG added to PHT, phenobarbital (PB), lorazepam, sertraline, and thioridazine produced irritability, hyperactivity, and poor cooperation. In patient 6, a 29-year-old woman, LTG added to VPA produced frequent screaming, temper tantrums, increased rocking movements, and hyperactivity. In patient 7, a 29-year-old man, LTG added to VPA and PHT resulted in severe exacerbation of baseline behaviors, including self-injurious activity, temper tantrums, and failure to obey simple instructions.


CONCLUSIONS
In some patients with epilepsy and MR, LTG has significant positive or negative effects on behavior.
Department of Neurology, State University of New York at Stony Brook, 11794-8121, USA.
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Ettinger
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Weisbrot
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J
Saracco
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A
Dhoon
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Kanner
O
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Devinsky
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000494:pharmacology* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006948:Hyperkinesis / Q000188:drug therapy / Q000523:psychology; D008607:Intellectual Disability / Q000188:drug therapy* / Q000523:psychology*; D007508:Irritable Mood / Q000187:drug effects; D000077213:Lamotrigine; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000523:psychology; D019956:Stereotypic Movement Disorder / Q000188:drug therapy / Q000523:psychology; D014227:Triazines / Q000494:pharmacology* / Q000627:therapeutic use
D000927:Anticonvulsants; D014227:Triazines; D000077213:Lamotrigine