title: An association of intrusive, repetitive phrases with lamotrigine treatment in bipolar II disorder.
abstract: BACKGROUND
  Bipolar disorder is frequently associated with obsessional symptoms. However, no reports have identified a pattern of obsessionality that is associated with a specific mood stabilizer treatment.
  
  
  METHODS
  A chart review was conducted on five patients with bipolar II disorder who spontaneously reported a form of obsessionality characterized by intrusive, recurrent phrases after taking lamotrigine.
  
  
  RESULTS
  Development of the phrases occurred from 7-42 years after mood disorder onset and occurred only after initiation of lamotrigine treatment. The phrases improved with lamotrigine discontinuation or dose reduction and recurred with lamotrigine re-challenge or upon dose escalation.
  
  
  CONCLUSIONS
  A possible mechanism for the development of the intrusive phrases involves the influence of lamotrigine on glutamatergic regulation in a bipolar II disorder population vulnerable to the expression of obsessionality. Limitations of this report include its observational nature, small number of cases reported, and confound of concomitant medication use.
authors.affiliation: Bipolar Disorder Research Center, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA. kemp.david@gmail.com
authors.forename: David E
authors.initials: DE
authors.lastname: Kemp
authors.forename: William S
authors.initials: WS
authors.lastname: Gilmer
authors.forename: Jenelle
authors.initials: J
authors.lastname: Fleck
authors.forename: Pedro L
authors.initials: PL
authors.lastname: Dago
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy*; D003702:Delusions / Q000139:chemically induced; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D008875:Middle Aged; D009146:Music; D009770:Obsessive Behavior / Q000139:chemically induced*; D012008:Recurrence; D012660:Semantics; D013850:Thinking / Q000187:drug effects*; D014227:Triazines / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D014227:Triazines; D000077213:Lamotrigine