DJN has received research support from Eli Lilly & Co., GlaxoSmithKline, Janssen, Wyeth, NARSAD and NIH; and speakers honoraria from AstraZeneca, Eli Lilly & Co., GlaxoSmithKline, and Pfizer. ZNS has received research support from GlaxoSmithKline, NIH, and Wyeth; has served on the advisory boards for Wyeth, Bristol-Myers Squibb and GlaxoSmithKline; and has received speakers honoraria from Eli Lilly & Co., GlaxoSmithKline, Pfizer, and Wyeth. ACV has received research support from AstraZeneca, a Harvard Medical School Fellowship, NARSAD, NIH, and the Stanley Institute; and has served as a consultant or received speakers honoraria from GlaxoSmithKline and Novartis. MRC and SJ have received NIH research support. BK has received research support from Bristol-Myers Squibb, Cyberonics, Eli Lilly & Co., Forest, Janssen, NIH, Novartis, and Wyeth. PBP has received research support from GlaxoSmithKline, NIH, and Pfizer; has served on the advisory boards for GlaxoSmithKline, SleepMed Digitrace, and UCB Pharma; and received speakers honoraria from GlaxoSmithKline and UCB Pharma. RJB has had research or consulting relationships but no equity holdings with the following companies: Auritec, Biotrofix, Eli Lilly & Co., IFI SpA, Janssen, JDS, Merck, NeuroHealing, Novartis, and Solvay, as well as NIH grant support.
Lamotrigine in bipolar disorder: efficacy during pregnancy
Version of Record online: 8 APR 2008
© 2008 Blackwell Munksgaard
Volume 10, Issue 3, pages 432–436, May 2008
How to Cite
Newport, D. J., Stowe, Z. N., Viguera, A. C., Calamaras, M. R., Juric, S., Knight, B., Pennell, P. B. and Baldessarini, R. J. (2008), Lamotrigine in bipolar disorder: efficacy during pregnancy. Bipolar Disorders, 10: 432–436. doi: 10.1111/j.1399-5618.2007.00565.x
- Issue online: 8 APR 2008
- Version of Record online: 8 APR 2008
- Received 15 February 2007, revised and accepted for publication 30 April 2007
- bipolar disorder;
- mood stabilizers;
- treatment discontinuation;
Objective: Clinical management of bipolar disorder (BPD) patients during pregnancy is a major challenge. The high risk of bipolar depression during pregnancy encourages consideration of lamotrigine (LTG). We therefore compared recurrence risks among pregnant women with BPD treated with LTG to those discontinuing mood stabilizer therapies.
Methods: We compared risks and weeks to new DSM-IV illness-episodes among 26 initially clinically stable pregnant women diagnosed with DSM-IV BPD who continued LTG treatment to those discontinuing all mood stabilizer treatment during pregnancy.
Results: The risk of new illness-episodes with LTG was 30% versus 100% after discontinuing mood stabilizers, and survival-computed time-to-25%-recurrence was 28.0 versus 2.0 weeks (χ2 = 17.3, p < 0.0001; hazard ratio = 12.1; 95% confidence interval = 1.6–91.7).
Conclusions: Discontinuing mood stabilizer treatment presents high risks of illness-recurrence among pregnant women diagnosed with BPD. LTG may afford protective effects in pregnancy, and its reported fetal safety compares favorably to other agents used to manage BPD.