| Additional Notes: | Lamotrigine is an antiepileptic drug that is used for monotherapy as well as combination therapy in the treatment of various seizure disorders in both adults and children. It has also been used for the prevention of depressive episodes in bipolar disorder. Further it occasionally is used to augment clozapine in patients with refractory schizophrenia. Lamotrigine is glucuronated to an inactive metabolite and importantly enzyme inhibition or enzyme induction will affect plasma levels. In a group of 811 outpatients with epilepsy who had received Lamotrigine increasing plasma levels were associated with higher toxicity rates (1). This seemed to increase above 15 mg/L. Hiemke et al. in their consensus guidelines recommend a therapeutic range of 3 to 15 mg/L (2).
Suggested therapeutic range: 3 to 15 mg/L
- Hirsch LJ, Weintraub D, Du Y, Buchsbaum R, Spencer HT, Hager M, Straka T, Bazil CW, Adams DJ, Resor SR Jr, Morrell MJ. Correlating lamotrigine serum concentrations with tolerability in patients with epilepsy. Neurology. 2004 Sep 28;63(6):1022-6. doi: 10.1212/01.wnl.0000138424.33979.0c. PMID: 15452293
- Hiemke C, Bergemann N, Clement HW, et al. Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology: Update 2017. Pharmacopsychiatry. 2018 Jan;51(1-02):e1. doi: 10.1055/s-0037-1600991. Epub 2018 Feb 1.
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