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Anger with murderous impulse induced by lamotrigine.
Shinnosuke Saito1, Katsutoshi Shioda1, Kouichi Nisijima1
1Department of Psychiatry, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke City, Tochigi 329-0498, Japan.
General Hospital Psychiatry
|April 17, 2014
Summary
Lamotrigine (LTG) can induce severe anger and murderous impulses in patients with mood disorders. Physicians should monitor for this rare adverse effect, even when LTG is prescribed for depression.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Major depressive disorder (MDD) is a common and debilitating mental health condition.
- Lamotrigine (LTG) is an anticonvulsant medication often used as a mood stabilizer in bipolar disorder and sometimes for depression.
- Antidepressant and mood-stabilizing medications can have complex effects on mood and behavior.
Observation:
- Two cases of major depressive disorder are presented.
- Lamotrigine was initiated in both patients to treat their depressive episodes.
- Both patients experienced severe anger with murderous impulses during LTG treatment.
Findings:
- Case 1: A 22-year-old male developed anger and murderous impulses at 125 mg/day of LTG; symptoms resolved upon dose reduction to 75 mg/day.
- Case 2: A 23-year-old female experienced immediate resolution of anger and murderous impulses upon discontinuation of LTG (25 mg/day).
Implications:
- These cases suggest a potential link between lamotrigine (LTG) and the induction of severe anger with murderous impulses in patients with mood disorders.
- This adverse effect, though infrequent, warrants clinical awareness, particularly in patients with a history of aggression or violent behavior.
- Healthcare providers should carefully monitor patients for behavioral changes when initiating or adjusting LTG dosages for mood disorders.
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