Lamotrigine for attention deficit-hyperactivity disorder comorbid with mood disorders: a case series

Attention deficit-hyperactivity disorder (ADHD) is frequently comorbid with mood disorders in both children and adults. Comorbidity is shown to have negative consequences and it needs to be treated effectively. Lamotrigine, an anticonvulsant indicated for the maintenance treatment of bipolar depression is reported to be effective in adult ADHD comorbid with bipolar II disorder. We conducted a retrospective chart review to identify patients with adult ADHD and comorbid mood disorders on lamotrigine, along with ADHD medications, and/or antidepressants and antipsychotics. We identified 40 patients (17 women, 42.5%; age range 16 - 55 yrs), 50% with bipolar II and 50% with recurrent depression. Their treatment response was evaluated by Clinical Global Impression scales. We found that 31 patients (77.5%) improved with lamotrigine, there was no change in 7 patients (17.5%) and 2 patients got worse, with a mean lamotrigine dose of 125.6 ± 47.8 mg (25 - 250 mg). To our knowledge, this is the first study to report that lamotrigine might be a safe and effective treatment option for adult ADHD comorbid with bipolar and recurrent depression.