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Re: will try to get lamictal » adamie

Posted by Cam W. on November 1, 2001, at 18:23:58

In reply to will try to get lamictal » JohnX2, posted by adamie on October 28, 2001, at 12:08:58

Judy - Personally, I have not seen much success using Lamictal™ (lamotrigine) as monotherapy in clinical situation (mind you, I have only seen a few Lamictal monotherapy regimens at the stores I have worked at). It is usually used as an adjunct to other mood stabilizers, like lithium and Epival™ (Depakote™ - divalproex).

A few placebo-controlled trials (both company- and NIMH-funded) have been done using Lamictal as a monotherapy and in conjunction with another mood stabilizer, in both Bipolar I and Bipolar II patients. Although there were some potential methodologicaal errors in the ways the studies were conducted (eg. no rapid cyclers in a couple of studies; one study was all rapid cyclers; one study was open label; one study, only BPII responded; one study incl. tapering off of lithium which can lead to relapse; one study only used patients already stabilized on Lamictal; etc.) all the studies seemed to end up with about a 50% lamictal response rate and a 20% placebo response rate (weird, huh?).

So, no matter what you do (use Lamictal with lithium, or by itself), you seem to have a 50-50 chance of having a response to it. I'd be interested to see a "Lamictal Monotherapy v. Lamictal-Depakote" study, but I haven't seen one, yet.

Sorry to make your decision even more confusing. - Cam




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