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Positive and Negative Psychotropic Effects of Lamotrigine in Patients with Epilepsy and Mental Retardation |
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| Authors: | Alan B. Ettinger§ ,Deborah M. Weisbrot&dagger § ,Jennifer Saracco&Dagger § ,Aliasgar Dhoon&Dagger § ,res Kanner,&# ,Yorrin Devinsky¶ |
| Affiliation: | Departments of Neurology, State University of New York af Stony Brook, Stony Brook, New York;Departments of Psychiatry, State University of New York af Stony Brook, Stony Brook, New York;Departments of Psychology, State University of New York af Stony Brook, Stony Brook, New York;Epilepsy Management Program, State University of New York af Stony Brook, Stony Brook, New York;Department of Neurology, Rush Presbyterian Medical Center, Chicago, Illinois;Department of Neurology, The Comprehensive Epilepsy Center, New York University School of Medicine, Hospital for Joint Diseases Orthopaedic Institute, New York, New York, U.S.A. |
| Abstract: | Summary: 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. |
| Keywords: | Lamotrigine Psychotropic Epilepsy Behavior Mental retardation |