Efficacy and Safety of Lamotrigine for Adults with Bipolar Disorder in a Private Practice Setting

INTRODUCTION: Lamotrigine is approved by the Food and Drug Administration for maintenance therapy in patients with bipolar I disorder. However, several studies of acute-phase and maintenance treatment support the efficacy of lamotrigine for bipolar I and bipolar II disorders. This chart review was performed to assess the efficacy and safety of lamotrigine in the treatment of bipolar disorder in a private psychiatric practice setting and to investigate differences in response among patients with different diagnostic subtypes of bipolar disorder. METHODS: The charts of 587 adult outpatients with a primary diagnosis of bipolar disorder who received treatment with lamotrigine in a private practice setting between July 1998 and May 2004 were reviewed retrospectively. Treatment response was assessed with the Clinical Global Impression-Improvement scale and was defined as achievement of a score of <2. RESULTS: Three hundred forty-nine patients (59.5%) responded to lamotrigine. Response rates were comparable among patients with bipolar I disorder, bipolar II disorder, bipolar disorder not otherwise specified, and among patients with bipolar I disorder who presented with depressive, manic, or mixed episodes. Nonserious rash (12.8%) and headache (2.9%) were the most frequently reported adverse events. CONCLUSION: These results suggest that lamotrigine is effective and well-tolerated in the treatment of bipolar disorder across the spectrum of subtypes of the illness.