Manic switch after adjuvant lamotrigine treatment

Year 2012, , 129 - 32, 01.03.2012

Meliha Zengin Eroğlu Gonca Karakuş Lut Tamam

https://doi.org/10.5455/jmood.20120711044809

Abstract

The neurobiology of switching phenomenon is unclear and no common definition exists to describe it. Several factors such as neurobiological problems, sleep deprivation, and drugs appear to be associated with mood switches. Frequently accused drugs are exogenous corticosteroids, dopaminergic agonists, and antidepressants. Lamotrigine is a mood stabilizer that is used in the treatment of treatment-resistant unipolar depression and bipolar depression. In many clinical trials, manic or hypomanic switch risk of lamotrigine has been reported to be not more than placebo. Here, we report a female patient with recurrent depressive disorder who developed manic switch after adding lamotrigine to her treatment regimen.

Keywords

-

Lamotrijin ekleme tedavisi sonrası manik kayma

Abstract

Kayma fenomeninin nörobiyolojisi tam olarak bilinmemektedir ve bu durumu açıklayan net bir tanımlama bulunmamaktadır. Nörobiyolojik sorunlar, uyku yoksunluğu ve ilaçlar gibi pek çok etmen duygudurum oynamalarıyla ilişkili gibi görünmektedir. En sık suçlanan ilaçlar dış kaynaklı kortikosteroidler, dopaminerjik agonistler ve antidepresanlardır. Lamotrijin tedaviye dirençli tek uçlu ve iki uçlu depresyon tedavisinde kullanılan bir duygudurum dengeleyicidir. Pek çok klinik çalışmada lamotrijinin mani ya da hipomani yapma riskinin plasebodan fazla olmadığı gösterilmiştir. Bu olgu sunumunda tekrarlayan depresif atakları olan ve lamotrijin ekleme tedavisi sonrası manik kayma yaşayan bir kadın hasta sunulmuştur.

Keywords

manik kayma, lamotrijin, ekleme tedavisi

References

• Salvadore G, Quiroz JA, Machado-Vieira R, Henter ID, Manji HK, Zarate CA Jr. The neurobiology of the switch process in bipolar disorder:a review. J Clin Psychiatry 2010;71:1488-501.
• Margolose HC, Beauclair L, Szkrumelak N, Chouinard G. Hypomania induced by adjunctive lamotrigine. Am J Psychiatry 2003;160:183-4.
• Desarkar P, Sinha VK. Lamotrigine-induced severe manic switch. Aust N Z J Psychiatry 2006;40:718.
• Savas HA, Selek S, Bulbul F, Kaya MC, Savas E. Successful treatment with lamotrigine in bipolar depression: a study from Turkey. Aust N Z J Psychiatry 2006; 40:498-500.
• Kugaya A, Sanacora G. Beyond monoamines:glutamatergic function in mood disorders. CNS Spectr 2005;10:808-19.
• Bhagwagar Z, Goodwin GM. Lamotrigine in the treatment of bipolar disorder. Expert Opin Pharmacother 2005;6:1401-8.
• Rocha FL, Hara C. Lamotrigine augmentation in unipolar depression. Int Clin Psychopharmacol 2003;18:97-9.
• Post RM, Altshuler LL, Leverich GS, Frye MA, Nolen WA, Kupka RW, Suppes T, McElroy S, Keck PE, Denicoff KD, Grunze H, Walden J, Kitchen CM, Mintz J. Mood switch in bipolar depression: comparison of adjunctive venlafaxine, bupropion and sertraline. Br J Psychiatry 2006;189:124-31.
• Amsterdam JD, Shults J. Comparison of short-term venlafaxine versus lithium monotherapy for bipolar II major depressive episode:a randomized open-label study. J Clin Psychopharmacol 2008;28:171-81.
• Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, Janecek E, Domecq C, Greenblatt DJ. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981;30:239-43.
• Bottlender R, Sato T, Kleindienst N, Strauss A, Möller HJ. Mixed depressive features predict maniform switch during treatment of depression in bipolar I disorder. J Affect Disord 2004;78:149-52.
• Zarate CA Jr, Tohen M, Fletcher K. Cycling into depression from a first episode of mania:a case-comparison study. Am J Psychiatry 2001;158:1524-6.
• Raskin S, Teitelbaum A, Zislin J, Durst R. Adjunctive lamotrigine as a possible mania inducer in bipolar patients. Am J Psychiatry 2006;163:159-60.