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Is there a lamotrigine withdrawal syndrome?
Ph Gelisse1, N Kissani, A Crespel
1Epilepsy Unit, Gui de Chauliac Hospital, Montpellier, France. p_gelisse@hotmail.com
Acta Neurologica Scandinavica
|March 12, 2002
Summary
Rapidly stopping lamotrigine (LTG) in a patient led to a psychomotor inhibition state. This withdrawal reaction, characterized by anhedonia and tremors, resolved spontaneously, highlighting potential LTG pharmacodynamic effects.
Area of Science:
- Neurology
- Pharmacology
Background:
- Antiepileptic drugs (AEDs) are crucial for managing epilepsy.
- Abrupt cessation of AEDs can precipitate withdrawal syndromes.
- Lamotrigine (LTG) is a commonly prescribed AED.
Observation:
- A 26-year-old male patient underwent presurgical evaluation for epilepsy.
- His treatment, including valproate (VPA) and LTG, was rapidly decreased and discontinued over 4 days.
- LTG was stopped due to ineffectiveness in seizure control.
Findings:
- Following LTG cessation, the patient developed anhedonia, tremor, tachycardia, and hyperhidrosis.
- These symptoms were consistent with a withdrawal reaction to lamotrigine.
- The patient's symptoms resolved spontaneously within a few days.
Implications:
- This case suggests that rapid lamotrigine withdrawal can induce a psychomotor inhibition state.
- Withdrawal syndromes from AEDs are rarely reported but can occur.
- The observed reaction may be linked to the proposed psychostimulant and antidepressive effects of lamotrigine.