A Predictive Model of Plasma Lamotrigine Levels.
Introduction:Lamotrigine is one of several mood stabilizers and its effects for the treatment and prevention of depressive episodes, particularly in bipolar disorder, are generally accepted. Although the findings about a therapeutic window of lamotrigine are yet to be determined, it seems important to obtain information on individual pharmacokinetic peculiarities. This study was conducted to formulate the predictive model of plasma lamotrigine levels.Methods:Using the data of 47 patients whose lamotrigine levels, liver function, and renal function were measured, predictive models of lamotrigine levels were formulated by stepwise multiple regression analyses. The predictive power of the models was compared using another dataset of 25 patients.Results:Two models were created using stepwise multiple regression. The first model was: plasma lamotrigine level (μg/mL)=2.308+0.019×lamotrigine dose (mg/day). The second model was: plasma lamotrigine level (μg/mL)=0.08+0.024×lamotrigine dose (mg/day)+4.088×valproate combination (no=0, yes=1). The predictive power of the second model was better than that of the first model.Discussion:The present study proposes a prompt and relatively accurate equation to predict lamotrigine levels.
Department of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Japan.
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Kamei
Department of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Japan.
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Terao
Department of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Japan.
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Katayama
Department of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Japan.
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Hatano
Department of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Japan.
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Kodama
Department of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Japan.
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Shirahama
Department of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Japan.
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Sakai
Department of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Japan.
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Hirakawa
Department of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Japan.
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Mizokami
Department of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Japan.
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Shiotsuki
Department of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Japan.
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Ishii
General Research Clinical Center, Oita University Hospital, Japan.
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Inoue
D000328:Adult; D018692:Antimanic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000097:blood* / Q000188:drug therapy; D018691:Excitatory Amino Acid Antagonists / Q000097:blood* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000502:physiology; D000077213:Lamotrigine; D008099:Liver / Q000187:drug effects / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012044:Regression Analysis; D014227:Triazines / Q000097:blood* / Q000627:therapeutic use; D014635:Valproic Acid / Q000627:therapeutic use
D018692:Antimanic Agents; D018691:Excitatory Amino Acid Antagonists; D014227:Triazines; D014635:Valproic Acid; D000077213:Lamotrigine