Open-label trial of lamotrigine focusing on efficacy in vulvodynia.
OBJECTIVE
Chronic pelvic pain (CPP) affects 15% of women and has a high rate of psychiatric comorbidity. Vulvodynia, a vulvar pain syndrome that includes vulvar vestibulitis, is the most common subtype of CPP. This study examined the efficacy of lamotrigine for the treatment of CPP using an open-label design.


METHODS
Forty-three women with CPP were recruited from a specialty pelvic pain clinic. Of these, 31 completed 8 weeks of active treatment. Outcome variables included the McGill Pain Rating Index and subscales of pain intensity and the Hamilton Depression and Anxiety Rating Scales.


RESULTS
We found significant reductions in all pain and mood measures at the 8-week visit compared to baseline. In particular, women with vulvodynia-type CPP (N = 17) had robust reductions in pain and mood symptoms.


CONCLUSIONS
CPP is a heterogeneous disorder, with psychiatric comorbidity and poor treatment response. This open-label study suggests that treatment with lamotrigine in women with the vulvodynia subtype of CPP may be helpful in addressing both the pain and mood symptoms associated with this disorder.
Department of Psychiatry, University of North Carolina at Chapel Hill, Campus Box 7160, Chapel Hill, NC 27599, USA. meltzerb@med.unc.edu
Samantha E
SE
Meltzer-Brody
Denniz
D
Zolnoun
John F
JF
Steege
Katherine L
KL
Rinaldi
Jane
J
Leserman
D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D001007:Anxiety / Q000188:drug therapy / Q000453:epidemiology; D015897:Comorbidity; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008875:Middle Aged; D010147:Pain Measurement / Q000187:drug effects / Q000523:psychology; D017699:Pelvic Pain / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D014227:Triazines / Q000627:therapeutic use*; D014845:Vulvar Diseases / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D055815:Young Adult
D000700:Analgesics; D014227:Triazines; D000077213:Lamotrigine