title: Discovery and development of lamotrigine for bipolar disorder: a story of serendipity, clinical observations, risk taking, and persistence.
abstract: This paper briefly reviews and comments on the development of lamotrigine as a treatment for bipolar disorder. The events described include astute clinical observations by epileptologists, serendipitous coupling of the drug's clinical profile to unmet need of two refractory bipolar patients by a practicing psychiatrist, risk taking on the part of an industry sponsor, and persistence on the part of a few key internal and external advocates to see development through to its conclusion, taking place against a backdrop of a disease area which, at the time of the earliest events described here, had not seen the development of any new pharmacologic treatments for decades. Fortunately for patients, since that time there has been a veritable explosion of research into treatments for bipolar disorder, both old and new, so that now patients and physicians have multiple evidence-based options for the treatment of this devastating illness. The development of lamotrigine provides one example of the importance of prescience, patience and persistence in bringing a novel idea to clinical fruition.
authors.affiliation: University of North Carolina at Chapel Hill and Duke University Medical Center, United States. rweisler@aol.com
authors.forename: Richard H
authors.initials: RH
authors.lastname: Weisler
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Calabrese
authors.forename: Charles L
authors.initials: CL
authors.lastname: Bowden
authors.forename: John A
authors.initials: JA
authors.lastname: Ascher
authors.forename: Joseph
authors.initials: J
authors.lastname: DeVeaugh-Geiss
authors.forename: Gary
authors.initials: G
authors.lastname: Evoniuk
mesh_terms: D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D018692:Antimanic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy*; D002220:Carbamazepine / Q000009:adverse effects / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004345:Drug Industry; D004827:Epilepsy / Q000188:drug therapy; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D016651:Lithium Carbonate / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D014227:Triazines / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; D018692:Antimanic Agents; D014227:Triazines; D016651:Lithium Carbonate; D002220:Carbamazepine; D000077213:Lamotrigine