background Lamotrigine is being prescribed increasingly for the treatment of bipolar disorder. In this article we review the current literature on the subject.
aim To review the literature in order to assess the present position of lamotrigine in the treatment of bipolar disorder.
method We reviewed the literature from 1985 to 2005 by means of PubMed and we also consulted the bibliographic references for the articles we found. In addition, we studied a review article by Goldsmith e. a. (2003).
results Although a considerable amount of research has been done, evidence for the efficacy of lamotrigine is limited. Lamotrigine was not effective in the treatment of acute mania. In only one of three studies was lamotrigine effective in the treatment of acute depression. In two extensive maintenance studies lamotrigine was found to be effective in preventing new depression episodes; however, the latter studies have such serious methodological weaknesses that the results provide only very limited evidence that lamotrigine is beneficial.
conclusion In the guideline for the treatment of bipolar depression published by the nvvp (the Dutch Psychiatric Association; 2001), lamotrigine was mentioned as a possible treatment option for bipolar disorder and rapid cycling. In view of the results of randomised controlled trials (rcts) that have been published so far, there is at present no reason to alter the status of lamotrigine