title: Effectiveness of lamotrigine in maintaining symptom control in pediatric bipolar disorder.
abstract: OBJECTIVE
  The aim of this study was to test the effectiveness and safety of lamotrigine in maintenance of manic and depressive symptom control in pediatric bipolar disorder (PBD).
  
  
  METHODS
  A 14-week open trial was conducted with 46 subjects presenting with mania or hypomania. Lamotrigine was slowly titrated to a therapeutic dose over an 8-week period, during which acute symptoms were stabilized using second-generation antipsychotics (SGA), followed by a 6-week lamotrigine monotherapy phase.
  
  
  RESULTS
  The response rate on manic symptoms (Young Mania Rating Score [YMRS] <12) was 72%, on depressive symptoms was 82% (Children's Depression Rating Scale-Revised [CDRS-R] <40), and the remission rate was 56% at the 14-week end point, on an average end-point lamotrigine dose of 1.8 mg/lb. There was further reduction in depressive symptoms during the lamotrigine maintenance phase. Benign rash was noted in 6.4% of patients. Out of half of the subjects who were in remission at 8 week, 3 subjects (23%) relapsed by week 14.
  
  
  CONCLUSIONS
  Lamotrigine monotherapy appears to be effective in maintaining symptom control of manic and depressive symptoms in PBD and shows minimal adverse effects, although a future double-blind controlled trial is needed to confirm this finding. Portal of entry for lamotrigine treatment can be during acute illness and can sustain symptom control after establishing mood stabilization.
authors.affiliation: University of Illinois at Chicago, Chicago, Illinois, USA. mpavuluri@psych.uic.edu
authors.forename: Mani N
authors.initials: MN
authors.lastname: Pavuluri
authors.forename: David B
authors.initials: DB
authors.lastname: Henry
authors.forename: Melissa
authors.initials: M
authors.lastname: Moss
authors.forename: Tahseen
authors.initials: T
authors.lastname: Mohammed
authors.forename: Julie A
authors.initials: JA
authors.lastname: Carbray
authors.forename: John A
authors.initials: JA
authors.lastname: Sweeney
mesh_terms: D000293:Adolescent; D018692:Antimanic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy*; D002648:Child; D003866:Depressive Disorder / Q000188:drug therapy; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008134:Long-Term Care; D008297:Male; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D014227:Triazines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D018692:Antimanic Agents; D014227:Triazines; D000077213:Lamotrigine