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Talk:Lamotrigine: Difference between revisions
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'''Lamotrigine''', sold as the brand name '''Lamictal''' among others, is a medication used to treat [[epilepsy]] and stabilize mood in [[bipolar disorder]].<ref name=AHFS2017>{{cite web|title=Lamotrigine|url=https://www.drugs.com/monograph/lamotrigine.html|publisher=The American Society of Health-System Pharmacists|access-date= 8 December 2017}}</ref> For epilepsy, this includes [[focal seizure]]s, [[tonic-clonic seizure]]s, and seizures in [[Lennox-Gastaut syndrome]].<ref name=AHFS2017/> In bipolar disorder, lamotrigine has not been shown to reliably treat acute depression; but for patients with bipolar disorder who are not currently symptomatic, it appears to be effective in reducing the risk of future episodes of depression.<ref>{{cite web|title=Lamotrigine: Its Role in Bipolar Disorder|url=https://www.psychiatrictimes.com/view/lamotrigine-its-role-bipolar-disorder|publisher=PsychiatricTimes|access-date= 1 September 2020}}</ref> | |||
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Common side effects include nausea, sleepiness, headache, vomiting, trouble with coordination, and rash.<ref name=AHFS2017/> Serious side effects include [[hemolytic anemia|lack of red blood cells]], increased risk of [[suicide]], [[Stevens–Johnson syndrome]], and [[allergic reactions]].<ref name=AHFS2017/> Concerns exist that use during [[pregnancy]] or [[breastfeeding]] may result in harm.<ref name="Drugs.com pregnancy" /> Lamotrigine is a [[phenyltriazine]], making it chemically different from other anticonvulsants.<ref name=AHFS2017/> Its mechanism of action is not clear, but it appears to inhibit release of excitatory neurotransmitters via [[voltage-sensitive sodium channels]] and [[Voltage-gated calcium channel|voltage-gated calcium channels]] in neurons.<ref name=AHFS2017/><ref>{{cite web| url= https://pubchem.ncbi.nlm.nih.gov/compound/3878#section=Top| title= Lamotrigine| website= PubChem Open Chemistry Database| publisher= National Institutes of Health| location= US| access-date= 13 December 2016}}</ref> <ref>{{Cite journal|last=Goldsmith|first=David R.|last2=Wagstaff|first2=Antona J.|last3=Ibbotson|first3=Tim|last4=Perry|first4=Caroline M.|date=2003-10-01|title=Lamotrigine|url=https://doi.org/10.2165/00003495-200363190-00009|journal=Drugs|language=en|volume=63|issue=19|pages=2029–2050|doi=10.2165/00003495-200363190-00009|issn=1179-1950}}</ref> | |||
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Lamotrigine was first marketed in the United Kingdom in 1991, and approved for use in the United States in 1994.<ref name=AHFS2017/><ref>{{cite book | vauthors = Shorvon SD, Perucca E, Engel J |title=The Treatment of Epilepsy|publisher=John Wiley & Sons, Incorporated|isbn=9781118936993|page=1321|edition=4th|date=2015|url=https://books.google.com/books?id=ppKbCgAAQBAJ&pg=PT1535}}</ref> It is on the [[WHO Model List of Essential Medicines|World Health Organization's List of Essential Medicines]].<ref name="WHO21st">{{cite book | vauthors = ((World Health Organization)) | title = World Health Organization model list of essential medicines: 21st list 2019 | year = 2019 | hdl = 10665/325771 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO | hdl-access=free }}</ref> In 2019, it was the 71st most commonly prescribed medication in the United States, with more than 10{{nbsp}}million prescriptions.<ref>{{cite web |title=The Top 300 of 2019 |url=https://clincalc.com/DrugStats/Top300Drugs.aspx |website=ClinCalc |access-date=16 October 2021}}</ref><ref>{{cite web | title=Lamotrigine - Drug Usage Statistics | website=ClinCalc | url=https://clincalc.com/DrugStats/Drugs/Lamotrigine | access-date=16 October 2021}}</ref> | |||
==History and culture== | ==History and culture== | ||
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==Chemistry== | ==Chemistry== | ||
{{chemistry}} | {{chemistry}} | ||
Lamotrigine is a member of the sodium channel blocking class of antiepileptic drugs.[67] This may suppress the release of glutamate and aspartate, two dominant excitatory neurotransmitters in the central nervous system.[68] It is generally accepted to be a member of the sodium channel blocking class of antiepileptic drugs,[69] but it could have additional actions, since it has a broader spectrum of action than other sodium channel antiepileptic drugs such as phenytoin and is effective in the treatment of the depressed phase of bipolar disorder, whereas other sodium channel-blocking antiepileptic drugs are not, possibly on account of its sigma receptor activity. In addition, lamotrigine shares few side effects with other, unrelated anticonvulsants known to inhibit sodium channels, which further emphasizes its unique properties.[70] | |||
==Subjective effects== | ==Subjective effects== | ||
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You may select physical effects to add below [[Subjective effect index#Physical effects|here]]. | You may select physical effects to add below [[Subjective effect index#Physical effects|here]]. | ||
*'''[[Effect:: | *'''[[Effect::Sedation]]''' - Mild compared to benzodiazepines. | ||
*'''[[Effect:: | *'''[[Effect::Muscle relaxation]]''' | ||
*'''[[Effect:: | *'''[[Effect::Seizure suppression]]''' | ||
*'''[[Effect::Dehydration]]''' {{citation needed}} | |||
}} | |||
}} | }} | ||
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====Distortions==== | ====Distortions==== | ||
*'''[[Effect:: | *'''[[Effect::Drifting]]''' {{citation needed}} ''([[Drifting#Melting|melting]], [[Drifting#Flowing|flowing]], [[Drifting#Breathing|breathing]] and [[Drifting# morphing|morphing]])'' - This effect is relatively low compared to psychedelics. | ||
====[[Effect::Geometry]]==== | ====[[Effect::Geometry]]==== | ||
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You may select from a list of cognitive effects to add below [[Subjective effect index#Cognitive effects|here]]. | You may select from a list of cognitive effects to add below [[Subjective effect index#Cognitive effects|here]]. | ||
*'''[[Effect:: | *'''[[Effect::Mental stability increase]]''' | ||
*'''[[Effect::Dream potentiation]]''' {{citation needed}} | |||
*'''[[Effect::Cognitive effect2]]''' | *'''[[Effect::Cognitive effect2]]''' | ||
*'''[[Effect::Cognitive effect3]]''' | *'''[[Effect::Cognitive effect3]]''' | ||
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{{chemistry}} | {{chemistry}} | ||
==Pharmacology== | ==Pharmacology== | ||
Lamotrigine is a member of the sodium channel blocking class of antiepileptic drugs.This may suppress the release of glutamate and aspartate, two dominant excitatory neurotransmitters in the central nervous system.It is generally accepted to be a member of the sodium channel blocking class of antiepileptic drugs, but it could have additional actions, since it has a broader spectrum of action than other sodium channel antiepileptic drugs such as phenytoin and is effective in the treatment of the depressed phase of bipolar disorder, whereas other sodium channel-blocking antiepileptic drugs are not, possibly on account of its sigma receptor activity. In addition, lamotrigine shares few side effects with other, unrelated anticonvulsants known to inhibit sodium channels, which further emphasizes its unique properties. | |||
==Subjective effects== | ==Subjective effects== | ||