Abstracts

In spite of wide clinical use, there is a paucity of data on anticonvulsant drugs in elderly patients with psychiatric and neurological disorders. The authors conducted a systemized analysis of the literature on lamotrigine (LTG) therapy in elderly patients with BD, epilepsy, or dementia., The search included electronic databases, meeting abstracts and presentations., Fourteen reports included controlled trials, retrospective analyses, and case studies. Reports of LTG in geriatric BD suggest improvement in depression, core manic symptoms and delay in mood relapse. Mean dose in larger samples was 182-240 mg/day. Controlled trials in geriatric epilepsy demonstrated efficacy and tolerability comparable to gabapentin. Compared to carbamazepine, there were fewer treatment withdrawals and fewer cases of somnolence or rash in the lamotrigine group. Preliminary reports in dementia note improvement in cognition, agitation and depression. While elimination of LTG can be affected by increasing age, disposition is more directly impacted by concurrent anticonvulsant therapy. There is extensive variability in LTG concentration/dose (C/D) ratios across the age-span, but as a group C/D ratios increase through adulthood., LTG appears effective and was well tolerated in older adults with BD, epilepsy and dementia. Incidence and severity of adverse events appears similar to that established in younger patient populations., (Supported by GlaxoSmithKline.)