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Lamotrigine

3 5 Diamino 6 (2 3 Dichlorophenyl) as Triazine


Presentation

  • This case is presented to highlight the importance of early detection of rare fatal syndrome.[ncbi.nlm.nih.gov]
  • Individuals treated with combined valproate-lamotrigine rarely present late adverse effects (unrelated to introduction and titration).[ncbi.nlm.nih.gov]
  • We describe a case of oral hairy leukoplakia that presented with an atypical appearance in a patient on long-term anticonvulsant treatment with an aromatic antiepileptic, lamotrigine.[ncbi.nlm.nih.gov]
  • Lamotrigine is most commonly-prescribed drug among the newer antiepileptic drugs; hence, it has been selected for the present review.[ncbi.nlm.nih.gov]
  • Clinicians should be aware of this mode of presentation of DRESS syndrome.[ncbi.nlm.nih.gov]
Abnormal Eye Movement
  • The patients presented heterogeneous disturbances, including ataxia, vertigo, and headache, and rare movement disorders, such as tics and abnormal eye movements.[ncbi.nlm.nih.gov]
Dystonia
  • We will review common side effects of this medication and the previous reports of lamotrigine-associated dystonias. We will also discuss a possible underlying mechanism.[ncbi.nlm.nih.gov]

Workup

  • Diana Monaghan, Workup of Female Patients With Sleep Complaints, Sleep Disorders in Women, 10.1007/978-1-59745-115-4_3, (19-28), (2006). António Martins da Silva, Melissa Mendez, Chun Bai and S. R.[doi.org]
Pericardial Effusion
  • Cardiac magnetic resonance imaging showed minimal pericardial effusion and a minimal decrease in left ventricular function. He was hospitalized with the diagnosis of myocarditis.[ncbi.nlm.nih.gov]
Staphylococcus Aureus
  • Blood cultures grew Staphylococcus aureus and Escherichia coli, for which she received vancomycin, ciprofloxacin, and gentamicin.[doi.org]

Treatment

  • treatment failure for any reason related to treatment and treatment failure due to adverse events, but no different between drugs for treatment failure due to lack of efficacy.Time to first seizure (pooled HR adjusted for seizure type: 1.26, 95% CI 1.12[ncbi.nlm.nih.gov]
  • Of the patients who continued treatment for 6 months or longer, only 2 later discontinued treatment because of adverse effects.[ncbi.nlm.nih.gov]
  • Participants and investigators were all blinded to treatment until the end of the trial.[ncbi.nlm.nih.gov]
  • […] depressive disorder during an 8-week treatment with lamotrigine using an open-study design.[ncbi.nlm.nih.gov]
  • All patients suffered from treatment-resistant bipolar disorder that was refractory to treatments other than lamotrigine.[ncbi.nlm.nih.gov]

Prognosis

  • The overall prognosis was benign, confirmed by long-term follow-up until age 20, inkeeping with the diagnosis of BECTS.[ncbi.nlm.nih.gov]
  • The long‐term prognosis is poor; although the epilepsy often improves, complete seizure freedom is rare and conversely the mental and psychiatric disorders tend to worsen with time.[doi.org]

Etiology

  • Abstract We report the case of JW, a 66-year-old woman who presented with musical hallucinations and multiple etiological factors for these rare phenomena. We discuss these factors and the successful amelioration of her symptoms with lamotrigine.[ncbi.nlm.nih.gov]
  • If an etiology cannot be found during the evaluation of a myocarditis case, drug hypersensitivity should be considered. Changing the responsible drug for hypersensitivity may be beneficial for these patients.[ncbi.nlm.nih.gov]
  • […] reactions such as Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Evaluate patients who develop fever or rash promptly, and discontinue lamotrigine if HLH or another serious immune-related adverse reaction is suspected and an alternative etiology[reference.medscape.com]
  • Moreover, a consistent etiological model to explain these effects has yet to be proposed. Ever since the first description [ Cooper, 1955 ], reports about the incidence of post-toxic flashbacks show a wide variation.[doi.org]

Epidemiology

  • .), Antwerp, Belgium; Center for Clinical and Epidemiological Research Ferrara (A.N.), Italy; Health Service Executive (M.O.), Kildare, Ireland; Institute of Clinical Physiology-National Research Council (IFC-CNR) (A.P.), Pisa, Italy; Otto-von-Guericke[ncbi.nlm.nih.gov]
  • Gioia Baggiani, Luca Ambrosiani, Pierfranco Trincas, Caterina Burrai and Alberto Bocchetta, Psychotropic Medication of Acute Episodes of Mood Disorders: Current Prescription Attitude in Two Psychiatric Wards in Cagliari, Italy, Clinical Practice & Epidemiology[doi.org]
  • S. ( 2004 ) The epidemiology of depersonalisation and derealisation: a systematic review. Social Psychiatry and Psychiatric Epidemiology, 39, 9 – 18. Kaufman, K. R. & Gerner, R. ( 1998 ) Lamotrigine toxicity secondary to sertraline.[doi.org]
  • Prevalence, correlates, disability, and comorbidity of DSM–IV borderline personality disorder: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions.[doi.org]
  • The de facto US mental and addictive disorders service system: epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. Arch Gen Psychiatry 1993; 50: 85–94 PubMed CrossRef Google Scholar 3.[doi.org]
Sex distribution
Age distribution

Pathophysiology

  • Since there is evidence for gamma-aminobutyric acid (GABA) involvement in the pathophysiology and treatment response of patients with bipolar disorder, this study was designed to examine the effect of lamotrigine on plasma GABA levels in healthy humans[ncbi.nlm.nih.gov]
  • The search terms were antiepileptic medication or drug, migraine headache, neuropathic pain, pathophysiology, treatment, mechanism of action, gabapentin, lamotrigine, oxcar-bazepine, topiramate, and zonisamide.[citeseerx.ist.psu.edu]
  • […] be helpful Monitoring serum concentration of lamotrigine Assessing compliance Adjusting lamotrigine dose in patients receiving other anticonvulsant drugs which interact pharmacokinetically with lamotrigine Clinical Information Discusses physiology, pathophysiology[mayomedicallaboratories.com]
  • Scientific background Voltage-gated sodium (Na V ) channels contribute to physiological and pathophysiological electrical signaling in nerve and muscle cells.[alomone.com]

Prevention

  • Here, we conducted an explorative data analysis to investigate whether the preventive effect of lamotrigine on recurrence /relapse in BPII is better than in BPI.[ncbi.nlm.nih.gov]
  • The anticonvulsant lamotrigine is also used regularly to treat or prevent bipolar depressive episodes.[ncbi.nlm.nih.gov]
  • In fact, in the combined two maintenance RCTs, lamotrigine was effective in preventing mania more than placebo; it did have mania prevention benefit. It just had more benefit in prevention of depression.[psychiatryletter.org]
  • In a few cases, antiepileptic drugs have been useful in preventing HH attacks.[ncbi.nlm.nih.gov]
  • Introduction: Lamotrigine is one of several mood stabilizers and its effects for the treatment and prevention of depressive episodes, particularly in bipolar disorder, are generally accepted.[ncbi.nlm.nih.gov]

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