Lamotrigine Lamicital

Uses Clinical Depression Seizures: tonic-clonic, focal, partial, atonic or drop seizures,

absence seizure. Bipolar treatment without triggering, mania or hypomania. Treat peripheral neuropathy Trigeminal neuralgia Cluster headaches Migraines Borderline personality disorder

Clinical research Single blind for 3

months Lamotrigine is helpful to control seizures but

incresed tolerance develops to this drug within a short period of time and while starting on 25 mg increased dose to 100mg to take same effect, could be interaction with quetiapine, exedrin and melatonin.

Primarily interaction with Seroquel or Quetiapine might be interacting with Seroquel and as a stimulator of CYP450 system that decreases dose due to which tolerance to the drug develops.

Lamicital Increase seizure like activity and loss of

consciousness like drop seizures after a period free of seizures.

Restlessness Improves concentration and interaction Decreases withdrawal effect of antipsychotics like

Risperidone. Increase energy and decreased need for sleep,

adrenaline rush.

Lamotrigine Improves memory and mapping ability Increases talkativeness Can increase suicidal thoughts Decreases paranoid thought and ideation in psychotic patients. Decreases appetite. Increases feelings of sadness and apathy. Can lower threshold to Epileptic like activity in brain due to over

stimulation of hippocampus; learning and memory and Amygdala, mixed emotions.

Shortness of breath and COPD like symptoms: hypothesis might be affecting the activity of Medulla and the respiratory control center.

Lamicital Back pain and Neck pain, stiffness and Torticollis Ankylosing spondolitis Hyperreflexia Hyperclonus Agitation Argumentative Hyperclonus

Lamicital Muscle weakness Hypothesis: affects corticospinal and corticobulbar

pathways, bell’s palsy like effect cranial nerve 7 affected.

Inferior oblique eye muscle affected, eye can’t be raised. Orbicularis oculi affected CN 7 closing eyelid.

Ptosis CN 3 Side effect cross eyes, painful menses, dizziness, day time somnolence or narcolepsy.

Lamicital Toxic Epidermal Necrolysis or Steven’s Johnson Syndrome. Broad spectrum than other anticonvulsants like Phenytoin

and Carbamazepine. CNS depression Angioedema Depression Exacerbation Blood Dyscriasis Hypersensitivity Eosinophilia

Teratogenic Possibly teratogenicity and give folic acid

supplementation in first trimester. May cause developmental delay.

Mechanism Inhibits voltage dependent sodium channels.

Decreases presynaptic glutamate and aspartate release.

May induce its own metabolism Excreted in urine 94% and half life 25 hours.

Contraindications Hypersensitivity Abrupt withdrawal avoid Caution with renal impairment Caution with hepatic impairment. Caution with suicide risk Pregnancy first trimester Caution in PKU disorder

Thank you With best regards,

Priyanka Kalsi References : Wikipedia and Epocrates,

clinical trial for 3 months, shadowing Clinician Dr Palmen in Mayo Clinic

Psychiatrist.