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Lamotrigine is metabolized predominantly by glucuronic acid conjugation. Its major metabolite is an inactive 2-n-glucuronide conjugate. [83] Lamotrigine has fewer drug interactions than many anticonvulsant drugs, although pharmacokinetic interactions with carbamazepine, phenytoin and other hepatic enzyme-inducing medications may shorten half ...
Women who intend to become pregnant should switch to a different medication if possible or decrease their dose of valproate. [23] Women who become pregnant while taking valproate should be warned that it causes birth defects and cognitive impairment in the newborn, especially at high doses (although valproate is sometimes the only drug that can ...
Valproate is known to cause serious abnormalities or birth defects in the unborn child if taken during pregnancy, [7] [8] and is contra-indicated for women of childbearing age unless the drug is essential to their medical condition and the person is also prescribed a contraceptive.
Data from studies conducted on women taking antiepileptic drugs for non-epileptic reasons, including depression and bipolar disorder, show that if high doses of the drugs are taken during the first trimester of pregnancy then there is the potential of an increased risk of congenital malformations.
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Combining lamotrigine with sodium valproate increases the risk of SJS. [26] Nonsteroidal anti-inflammatory drugs (NSAIDs) are a rare cause of SJS in adults; the risk is higher for older patients, women, and those initiating treatment. [27] Typically, the symptoms of drug-induced SJS arise within a week of starting the medication.
Among bipolar patients taking anticonvulsants, those on lamotrigine have a better cognitive profile than those on carbamazepine, valproate, topiramate, and zonisamide. [ 36 ] Although decreased verbal memory and slowed psychomotor speed are common side effects of lithium use [ 37 ] [ 38 ] these side effects usually disappear after ...
In the United States, it is used to treat schizophrenia for people aged 13 years and older, as well as depressive episodes of bipolar disorder age 10 and over as a monotherapy, and in conjunction with lithium or valproate in adults. [24] In July 2013, lurasidone received approval for bipolar I depression. [25] [26] [27] [28]