Lamotrigine therapy in elderly patients with epilepsy, bipolar disorder or dementia.
BACKGROUND
In spite of circumstances that precipitate high use of anticonvulsants in geriatric populations, there is a paucity of data on the use of antiepileptic drugs in elderly patients with psychiatric and neurological disorders.


METHODS
Reports of lamotrigine therapy in elderly patients with epilepsy, bipolar disorder (BD), or dementia were identified by conducting an electronic search of major publication databases. Abstracts and presentations from professional meetings were searched as were the bibliographies of relevant articles.


RESULTS
Fourteen reports were identified, and included well-controlled prospective trials, retrospective analyses, and case reports of lamotrigine treatment. Controlled trials in elderly patients with epilepsy demonstrate efficacy and tolerability comparable to gabapentin. Improvement in bipolar depressive symptoms, improvement in core manic symptoms, and delay in mood relapse was reported in geriatric patients with BD. Preliminary case studies in patients with dementia note improvement in cognition and symptoms of agitation and depression.


CONCLUSIONS
Review of the available literature suggests lamotrigine is effective and well tolerated in elderly patients with epilepsy and relatively well-tolerated and may be effective in delaying mood relapse, particularly in the depressive pole, in patients with BD. While very limited literature suggests that lamotrigine may be effective and relatively well-tolerated in patients with dementia, further studies are needed.
Sajatovic
Martha
M
Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA. Martha.sajatovic@uhhs.com
Ramsay
Eugene
E
Nanry
Kevin
K
Thompson
Thomas
T
D000368:Aged; D000369:Aged, 80 and over; D000588:Amines / Q000009:adverse effects / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use*; D018692:Antimanic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy*; D002220:Carbamazepine / Q000009:adverse effects / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids / Q000009:adverse effects / Q000627:therapeutic use; D003704:Dementia / Q000188:drug therapy*; D004311:Double-Blind Method; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D000077206:Gabapentin; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014227:Triazines / Q000627:therapeutic use*; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects / Q000627:therapeutic use
D000588:Amines; D000927:Anticonvulsants; D018692:Antimanic Agents; D003509:Cyclohexanecarboxylic Acids; D014227:Triazines; D002220:Carbamazepine; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D000077213:Lamotrigine