Adjunctive lamotrigine treatment for adolescents with bipolar disorder: retrospective report of five cases.
BACKGROUND
Our aim was to evaluate the effectiveness, safety, and tolerability of adjunctive lamotrigine in the treatment of adolescents with bipolar disorder.


METHODS
We evaluated all patients under age 18 with Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) bipolar disorder in our outpatient clinic treated with lamotrigine, using the Clinical Global Impression (CGI) scale. We rated response with the CGI-Improvement (CGI-I) scale.


RESULTS
Five patients (mean age = 15.5 +/- 1.8 years; range = 14-17), 1 male and 4 females, were included. One patient (20%) had bipolar I disorder, 1 (20%) had bipolar II disorder, and 3 (60%) had bipolar disorder not otherwise specified (NOS). The polarity of the episode at baseline was depressive in all patients. The mean lamotrigine dose was 100 +/- 87.5 mg/day (1.67 +/- 1.39 mg/kg/day). The mean duration of treatment was 28 +/- 28 weeks. CGI significantly improved from 5 at baseline to 3 +/- 1 at endpoint (p = 0.011). Improvement was marked or moderate in 4 patients (80%) and minimal in 1 patient (20%). One patient referred to dizziness, and there were no reports of increased cycling, worsening of mania, or skin rash.


CONCLUSIONS
This open, retrospective chart review suggests that lamotrigine may be effective and well tolerated as an adjunctive treatment in adolescents with bipolar disorder. Controlled trials are needed.
Soutullo
Cesar A
CA
Child and Adolescent Psychiatry Unit, Department of Psychiatry and Medical Psychology, Clínica Universitaria, University of Navarra, 31008-Pamplona, Spain. csoutullo@unav.es
Díez-Suárez
Azucena
A
Figueroa-Quintana
Ana
A
D000293:Adolescent; D018692:Antimanic Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D014227:Triazines / Q000627:therapeutic use*
D018692:Antimanic Agents; D014150:Antipsychotic Agents; D014227:Triazines; D000077213:Lamotrigine