Lamotrigine in adolescent mood disorders: a retrospective chart review.

INTRODUCTION Treatment nonresponse in adolescent mood disorders is a major public health problem, as mood disorders in youth are associated with significant mortality by suicide, protracted course of illness, and recurrence into adulthood. Three studies with small sample sizes exist for lamotrigine in youth mood disorders. However, the risk of serious rash has limited its use in youth mood disorders. OBJECTIVE The aims of this study are to evaluate the preliminary effectiveness and safety of lamotrigine in adolescent mood disorders. METHODS Medical charts were retrospectively reviewed at three clinical sites for 42 adolescents treated with lamotrigine for a mood disorder. The Clinical Global Impression (CGI) Severity and Improvement scores were obtained at baseline and last visit. Treatment-emergent adverse effects were also obtained. RESULTS Improvement was seen in 22 subjects (52%). The mean daily lamotrigine dose was 114.8mg (SD 75.6), and the average duration of lamotrigine treatment was 29.1+/-31.8 weeks. The mean CGI-S score decreased from 4.9+/-1.0 at baseline to 3.5+/-1.4 at endpoint (z=3.204, p<0.002). Four subjects (10%) developed benign rash. CONCLUSIONS This study provides preliminary data that lamotrigine may be effective in adolescents with mood disorders. However, this study revealed that lamotrigine might be associated with a significant risk of benign rash.