Lamotrigine for the treatment of bipolar spectrum disorder: a chart review

Background: Bipolar spectrum disorders are highly prevalent and disabling but are often misdiagnosed and inadequately treated. The use of mood stabilizers may be an important treatment option. This study evaluated the effectiveness and safety of lamotrigine in bipolar spectrum patients. Methods: Retrospective follow-up of 34 charts of bipolar outpatients treated with lamotrigine in monotherapy or as add-on therapy. Clinic notes were used to score the Clinical Global Impression for Bipolar Disorders (CGI-BP-M) scale and to identify manic, hypomanic mixed or depressive relapses. Results: A mean dose of lamotrigine of 113.2 +/- 66.6 mg/day for a mean duration of 29.7 +/- 17.3 weeks (range 6-96 weeks) achieved remission on depression (score 1 on the CGI-BP-M depression subscale) in 47.1% of the patients. Eleven patients (32.4%) remained euthymic (score 1 on the CGI-BP-M overall subscale) during the follow-up, after initiating treatment with lamotrigine. Effectiveness of lamotrigine was greater for those patients diagnosed with bipolar spectrum disorders other than bipolar 1. Lamotrigne was well-tolerated and only two patients discontinued due to side effects. Limitations: Chart review is open to several biases. Conclusions: In this sample of bipolar spectrum patients, lamotrigine was a safe and effective treatment. (c) 2004 Elsevier B.V. All rights reserved.