Background: Our aim was to evaluate the effectiveness, safety, and tolerability of adjunctive lamotrigine in the treatment of adolescents with bipolar disorder.
Method: We evaluated all patients under age 18 with Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) bipolar disorder in our outpatient clinic treated with lamotrigine, using the Clinical Global Impression (CGI) scale. We rated response with the CGI-Improvement (CGI-I) scale.
Results: Five patients (mean age = 15.5 +/- 1.8 years; range = 14-17), 1 male and 4 females, were included. One patient (20%) had bipolar I disorder, 1 (20%) had bipolar II disorder, and 3 (60%) had bipolar disorder not otherwise specified (NOS). The polarity of the episode at baseline was depressive in all patients. The mean lamotrigine dose was 100 +/- 87.5 mg/day (1.67 +/- 1.39 mg/kg/day). The mean duration of treatment was 28 +/- 28 weeks. CGI significantly improved from 5 at baseline to 3 +/- 1 at endpoint (p = 0.011). Improvement was marked or moderate in 4 patients (80%) and minimal in 1 patient (20%). One patient referred to dizziness, and there were no reports of increased cycling, worsening of mania, or skin rash.
Conclusions: This open, retrospective chart review suggests that lamotrigine may be effective and well tolerated as an adjunctive treatment in adolescents with bipolar disorder. Controlled trials are needed.