Lamotrigine treatment of adolescents with unipolar and bipolar depression: a retrospective chart review.

ABSTRACT

OBJECTIVE: The purpose of this study was to investigate the preliminary effectiveness and safety of lamotrigine for the treatment of depressive episodes in adolescents. METHODS: This was a 12 week retrospective chart review of lamotrigine treatment among 37 adolescents (mean age 16.3±1.3 years) with depressive episodes (15 with bipolar disorder and 22 with major depressive disorder). Illness severity at the 4th, 8th, and 12th weeks were retrospectively scored using Clinical Global Impressions - Severity (CGI-S) and Clinical Global Impressions - Improvement (CGI-I). RESULTS: The mean dose of lamotrigine was 65.4±37.5 mg/day (range 12.5-181.7 mg/day) for a mean duration of 199.9±217.4 days (range 14-879 days). The CGI-S scores were significantly decreased over 12 weeks (F=39.611, p<0.001, partial η2=0.531). Seventeen subjects (45.9%) showed a treatment response at 12 week follow up (defined by a CGI-I score ≤2). There were no differences in treatment effectiveness between the bipolar and unipolar groups. Overall, lamotrigine was well tolerated. The most common adverse event was skin rash (n=5, 13.5%), which resolved spontaneously after drug discontinuation. CONCLUSION: Our results provide preliminary evidence of the effectiveness and safety of lamotrigine in adolescents with bipolar and depressive disorders. Large, prospective, placebo-controlled studies are needed to confirm these findings.