The DOI matches its Crossref record; 11 of the 11 references it cites were found in a registry or an index.
Retrospective Analysis of Therapeutic Drug Monitoring Data for Treatment of Bipolar Disorder with Lamotrigine
Open accessAbstract
INTRODUCTION: Lamotrigine is licensed for treatment of epilepsy and prevention or at least delay of depressive episodes in bipolar disorder. The accepted therapeutic reference range (TRR) of lamotrigine for anticonvulsant treatment is 3 000-14 000 ng/ml. This TRR is often used for the therapy of bipolar disorders as well. This work presents serious doubts about this approach. METHODS: KONBEST, a large TDM database containing patients' characteristics including diagnoses, doses, comedication and serum concentrations, was analyzed. Out of a total of 3 459 lamotrigine samples, 360 patients suffered from bipolar disorder. 82 of them benefitted from therapy with lamotrigine as judged by the clinical global impression of improvement (CGI-I) scale. Patients with a score of minimally (3), much (2) or very much improved (1) were considered as responders. RESULTS: The recommended lamotrigine maintenance dose for bipolar disorder is 200 mg/day; the doses prescribed in our samples ranged from 25 to 450 mg/day. Only 32 concentrations (39.0%) fitted into the TRR recommended for therapy of epilepsy; 50 (61.0%) did not reach it, none exceeded it. The lowest concentration was 177 ng/ml, the highest 11 871 ng/ml. A mean lamotrigine serum concentration of 3 341±2 563 ng/ml (̅x±SD) was detected in the patients who benefitted. DISCUSSION: The authors conclude that in bipolar disorder lower lamotrigine serum concentrations lead to therapeutic benefit.
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“Across several different medications for bipolar depression, early improvement (after 2 weeks) has been found to be a reasonable predictor of overall response, whereas lack of early improvement is a more robust predictor of non‐response.255”
From Canadian Network for Mood and Anxiety Treatments ( CANMAT ) and International Society for Bipolar Disorders ( ISBD ) 2018 guidelines for the management of patients with bipolar disorder (2018) · cites this paper as [255]
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AGNP Consensus Guidelines for Therapeutic Drug Monitoring in Psychiatry: Update 2011
Hiemke, C., Baumann, P., Bergemann, N., Conca, A., Dietmaier, O., Egberts, K. M., Fric, M., Gerlach, M., Greiner, C., Gründer, G., et al. (2011) · Pharmacopsychiatry · doi:10.1055/s-0031-1286287 · Cited by 874
Self-citationGoa, K. L., Ross, S. R., & Chrisp, P. (1993) · Drugs · doi:10.2165/00003495-199346010-00009 · Cited by 308
Calabrese, J. R., Huffman, R., White, R. L., Edwards, S., Thompson, T. R., Ascher, J. A., Monaghan, E., & Leadbetter, R. A. (2008) · Bipolar Disorders · doi:10.1111/j.1399-5618.2007.00500.x · Cited by 247
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Therapeutic Drug Monitoring in Pharmacovigilance and Pharmacotherapy Safety
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Self-citationWalden, J., Schaerer, L., Schlösser, S., & Grunze, H. (2000) · Bipolar Disorders · doi:10.1034/j.1399-5618.2000.020408.x · Cited by 40
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Self-citationTherapeutic Window of Lamotrigine for Mood Disorders: A Naturalistic Retrospective Study
Katayama, Y., Terao, T., Kamei, K., Hatano, K., Kohno, K., Makino, M., Mizokami, Y., Kodama, K., & Itoh, H. (2014) · Pharmacopsychiatry · doi:10.1055/s-0034-1375618 · Cited by 19
Konbest – A Web-Based Laboratory Information Management System (LIMS) for TDM-Laboratories
Koestlbacher, A., & Haen, E. (2008) · Pharmacopsychiatry · doi:10.1055/s-0028-1088261 · Cited by 12
Self-citation
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Cited by
Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Bond, D. J., Frey, B. N., Sharma, V., Goldstein, B. I., Rej, S., Beaulieu, S., et al. (2018) · Bipolar Disorders · doi:10.1111/bdi.12609 · Cited by 1,852
Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology: Update 2017
Hiemke, C., Bergemann, N., Clement, H. ‐., Conca, A., Deckert, J., Domschke, K., Eckermann, G., Egberts, K. M., Gerlach, M., Greiner, C., et al. (2017) · Pharmacopsychiatry · doi:10.1055/s-0043-116492 · Cited by 1,535
Self-citationManagement of bipolar depression with lamotrigine: an antiepileptic mood stabilizer
Prabhavalkar, K. S., Poovanpallil, N. B., & Bhatt, L. K. (2015) · Frontiers in Pharmacology · doi:10.3389/fphar.2015.00242 · Cited by 76
Eap, C. B., Gründer, G., Baumann, P., Ansermot, N., Conca, A., Corruble, E., Crettol, S., Dahl, M., de León, J., Greiner, C., et al. (2021) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2021.1878427 · Cited by 51
Therapeutic Drug Monitoring in Psychiatry: Enhancing Treatment Precision and Patient Outcomes
Biso, L., Aringhieri, S., Carli, M., Scarselli, M., & Longoni, B. (2024) · Pharmaceuticals · doi:10.3390/ph17050642 · Cited by 49
Metadata
- Authors
- Unholzer, S., & Haen, E.
- Affiliations
- University of Regensburg (DE)
- Corresponding author
- Unholzer, S.
- ORCID
- Haen, E.
- Venue
- Pharmacopsychiatry
- Publisher
- Georg Thieme Verlag KG
- Published
- 2015-08-07
- Volume
- 48
- Issue
- 06
- Pages
- 211-214
- ISSN
- 0176-3679 (ISSN-L)
- 1439-0795
- OpenAlex
- W2259338861
- Cited by
- 22
- References
- 11
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 1 · 2023: 3 · 2021: 3 · 2020: 1 · 2019: 1 · 2018: 3 · 2017: 3 · 2016: 2 · 2015: 1
- FWCI
- 2.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Pharmacopsychiatry (publishedVersion)
- PubMed (publishedVersion)
- University of Regensburg Publication Server (University of Regensburg) (acceptedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
- Keywords
- lamotrigine, bipolar disorder, therapeutic drug monitoring, serum drug concentration, therapeutic window, anticonvulsant dosing, treatment response, dose-concentration relationship
- MeSH terms
- Lamotrigine, Adult, Aged, Aged, 80 and over, Anticonvulsants, Bipolar Disorder, Dose-Response Relationship, Drug, Female, Humans, Male, Retrospective Studies, Triazines, Drug Monitoring, Databases, Pharmaceutical
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