Lamotrigine (Lamotrigine)
Overview of Lamotrigine
Lamotrigine is a triazine derivarive and chemically Lamotrigine is idetified as 6-(2, 3-dichlorophenyl)-1, 2, 4-triazine-3, 5-diamine, prepared by chemical synthesis. Lamotrigine is oral antiepileptic and anticonvulsant agent developed based on the observation that some antiepileptic drugs possess antifolate activity. Although derived from agents which inhibit dihydrofolate reductase, it has relatively little antifolate activity. It blocks voltage dependent sodium channels. The exact mechanism by which it exhibits its anticonvulsant activity is not known, but studies suggest that it may stabilize neuronal membranes by acting at voltage-sensitive sodium channels. Blocking sodium channels can decrease the presynaptic release of glutamate, an excitatory amino acid, and aspartate resulting in decreased seizure frequency.it can be used alone or as a second-line, additional treatment in patients not staisfactorily controlled on other anticonvulsants.it was originally approved by the FDA December 28, 1994.
Indication of Lamotrigine
Lamotrigine is primarily indicated in conditions like Adjunctive therapy, Adjunctive therapy with valproate, Adjunctive therapy without valproate, Bipolar disorders, Epilepsy, Epilepsy (monotherapy), Monotherapy (epilepsy), Partial seizures, Seizures, Tonic-clonic seizures, and can also be given in adjunctive therapy as an alternative drug of choice in Generalised epilepsy with absence seizures.
Contraindication of Lamotrigine
Lamotrigine is contraindicated in conditions like Renal failure,Hepatic failure,Hypersensitivity.
Side Effects of Lamotrigine
The severe or irreversible adverse effects of Lamotrigine, which give rise to further complications include Ataxia, Thrombocytopenia, Aplastic anemia, Aplastic anemia, Stevens johnson syndrome, Epidermal necrolysis, Lymphadenopathy, Lymphadenopathy, Stevens johnson syndrome, Angioedema, Leucopenia, Neutropenia, Nystagmus, Extrapyramidal symptoms, Angioedema, Pancytopenia, Tremors, Epidermal necrolysis, Hepatic failure, Aplastic anemia, Facial edema, Choreoathetosis.,The symptomatic adverse reactions produced by Lamotrigine are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Headache, Drowsiness, Irritability, Ataxia, Nausea, Fever, Anxiety, Insomnia, Blurred vision, Maculopapular rash, Rashes, Confusion, Sedation, Malaise, Depression, Tremor, Diplopia, Arthralgia, SomnolenceX, Agitation, Anemia, Liver dysfunction, Aggression, Confusion, dizziness, Ataxia.
Precautions of Lamotrigine
Lamotrigine should be used with caution in patients with any pre-existing illness, especially of the heart, liver or kidneys or if have any drug allergy. Lamotrigine must be used with caution in patients under the age of 16 years due to insufficient information of use in this age group. Sunscreen or protective clothing is recommended to protect against possible severe rash triggered by sunlight. It should be used with caution while operating machinery or engaging in activities requiring alertness. Limit alcohol intake while taking this drug. It should be used only if clearly needed during pregnancy. The dose of lamotrigine in treatment of epilepsy with other AEDs should be gradually decreased over a period of 2 weeks because abrupt withdrawal of lamotrigine may provoke rebound seizures, unless safety concerns (e.g., rash) require an abrupt withdrawal. Physician should consider the possibility of a drug reaction in children that develop symptoms of rash and fever during the first eight weeks of therapy. All patients who develop a rash should be promptly evaluated and lamotrigine withdrawn immediatley unless the rash is clerarly not drug related.