title: Lamotrigine augmentation in schizophrenia and schizoaffective patients with obsessive-compulsive symptoms.
abstract: Obsessive-compulsive symptoms (OCS) are clinically important phenomena in schizophrenia patients. Lamotrigine has a modulating effect on glutamatergic neurotransmission relevant to pathophysiology of both schizophrenia and OCD. Efficacy and tolerability of lamotrigine in schizophrenia and schizoaffective patients with comorbid OCS were evaluated. In an 8-week, open-label trial, lamotrigine (25 mg/day for 1 week, 50 mg for 2 weeks, 100 mg for 2 weeks, 200 mg for 3 weeks) was added to ongoing psychotropic drug regimens in schizophrenia (N = 5) and schizoaffective disorder (N = 6) patients with clinically significant OCS [Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score > 16]. The Y-BOCS score for nine completers decreased significantly from baseline to week 8 (22.9 +/- 6.1 vs 17.4 +/- 3.6; t = 2.33, df = 1, P = 0.033). Five patients, all with schizoaffective disorder, were responders (>or=35% decrease in Y-BOCS score). No significant changes were detected in schizophrenia symptom severity. Depressive symptoms, assessed with the Calgary Depression Rating Scale, improved significantly (6.4 +/- 1.5 vs 4.0 +/- 2.5; t = 3.19, df = 1, P = 0.013); this change positively correlated with OCS improvement (r = 0.69, P = 0.04). Lamotrigine was safe and well tolerated. Explicit evaluation of therapeutic efficacy of adjunctive lamotrigine in schizoaffective disorder patients with comorbid OCS merits further investigation.
authors.affiliation: Research Unit, Tirat Carmel Mental Health Center, Rappaport Faculty of Medicine, Israel Institute of Technology - Technion, Haifa, Israel. poyurovs@tx.technion.ac.il
authors.forename: M
authors.initials: M
authors.lastname: Poyurovsky
authors.forename: I
authors.initials: I
authors.lastname: Glick
authors.forename: L M
authors.initials: LM
authors.lastname: Koran
mesh_terms: D000293:Adolescent; D000328:Adult; D018692:Antimanic Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003192:Compulsive Behavior / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D009770:Obsessive Behavior / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D018579:Patient Selection; D011618:Psychotic Disorders / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D012559:Schizophrenia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014227:Triazines / Q000627:therapeutic use*
chemical_list: D018692:Antimanic Agents; D014150:Antipsychotic Agents; D014227:Triazines; D000077213:Lamotrigine