Positive and negative psychotropic effects of lamotrigine in patients with epilepsy and mental retardation

Epilepsia. 1998 Aug;39(8):874-7. doi: 10.1111/j.1528-1157.1998.tb01183.x.


Purpose: To describe significant positive or negative psychotropic effects of lamotrigine (LTG) observed in epilepsy patients with mental retardation (MR).

Methods: Seven mentally retarded epilepsy patients, [5 with Lennox-Gastaut syndrome (LGS)] who experienced significant behavioral improvements or worsening after addition of LTG to their medication regimen were studied.

Results: LTG produced behavioral improvements in 4 patients. Patient 1, a 14-year-old girl, had LTG added to valproate (VPA) and thioridazine, resulting in diminished lethargy, less hyperactivity, and more appropriate speech. In a 17-year-old boy (patient 2) LTG added to VPA, phenytoin (PHT), and gabapentin (GBP) lessened irritability and hyperactivity. In patient 3, a 41-year-old woman, LTG added to PHT, VPA, and carbamazepine (CBZ) diminished lethargy and enhanced her social interactions. In patient 4, a 27-year-old man, LTG monotherapy diminished irritability and hyperactivity. Adverse behavioral effects were noted in 3 patients. In patient 5, a 43-year-old man, LTG added to PHT, phenobarbital (PB), lorazepam, sertraline, and thioridazine produced irritability, hyperactivity, and poor cooperation. In patient 6, a 29-year-old woman, LTG added to VPA produced frequent screaming, temper tantrums, increased rocking movements, and hyperactivity. In patient 7, a 29-year-old man, LTG added to VPA and PHT resulted in severe exacerbation of baseline behaviors, including self-injurious activity, temper tantrums, and failure to obey simple instructions.

Conclusions: In some patients with epilepsy and MR, LTG has significant positive or negative effects on behavior.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Anticonvulsants / pharmacology*
  • Anticonvulsants / therapeutic use
  • Drug Therapy, Combination
  • Epilepsy / drug therapy*
  • Epilepsy / psychology*
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperkinesis / drug therapy
  • Hyperkinesis / psychology
  • Intellectual Disability / drug therapy*
  • Intellectual Disability / psychology*
  • Irritable Mood / drug effects
  • Lamotrigine
  • Male
  • Mental Disorders / drug therapy*
  • Mental Disorders / psychology
  • Stereotypic Movement Disorder / drug therapy
  • Stereotypic Movement Disorder / psychology
  • Triazines / pharmacology*
  • Triazines / therapeutic use


  • Anticonvulsants
  • Triazines
  • Lamotrigine