Poster Session I

What is it about?

Introduction: To appraise the current evidence on the optimal serum level for Lamotrigine (LAM) in the treatment of mood disorders (Major Depressive disorder[MDD], bipolar disorder[BD]). Method: Major databases were searched for RCTs, open-label trials, and observational studies reporting serum LAM levels in adult patients treated with LAM for mood disorders. Studies were collected and analysed according to the Cochrane Handbook for Systematic Reviews of Interventions and overall quality was assessed by the GRADE approach. Results: A total of 814 abstracts were screened and 24 articles were selected for full-text review. Seven studies (226 BD and 17 MDD patients) including one RCT (n = 43), three prospective (n = 53), and three retrospective (n = 147) studies met the criteria. Study duration ranged from 6 to 96 weeks. LAM daily dosage varied from 25 to 425 mg/day among the studies. Studies reported inconsistent findings between LAM concentration and efficacy. Three studies did not identify a relationship between LAM levels and improvement in mood symptoms. One of the main limitations are the small sample sizes. Two studies (n = 99) reported higher response rates with a LAM level >3.25 µg/mL and one study (n = 25) reported a therapeutic window of 5–11 µg/mL. The overall quality of the included studies was low. LAM was overall well tolerated. A meta-analysis could not be performed due to a small number of heterogeneous studies. Conclusion: As of now findings are inconsistent to make any conclusive recommendations on LAM serum levels and efficacy in mood disorders. Further studies including larger sample sizes are required to address this relevant clinical question.

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Photo by micheile dot com on Unsplash