Efficacy and safety of lamotrigine in pediatric mood disorders: A systematic review

Autor: Rakesh Kumar, Juan Garzon, Deniz Yuruk, Leslie C. Hassett, Maria Saliba, Can Ozger, Cinar Oztosun, Kelly Ahern, Arjun P. Athreya, Balwinder Singh, Paul E. Croarkin, Jennifer L. Vande Voort
Rok vydání: 2022
Předmět:
Zdroj: Acta Psychiatrica Scandinavica. 147:248-256
ISSN: 1600-0447
0001-690X
Popis: To appraise the current evidence on the efficacy and safety of lamotrigine (LAM) in the treatment of pediatric mood disorders (PMD) (i.e., Major Depressive disorder [MDD], bipolar disorder [BD]).Major databases were searched for randomized controlled trials (RCTs), open-label trials, and observational studies reporting on pediatric (age 18 years) patients treated with LAM for mood disorders.A total of 3061 abstracts were screened and seven articles were selected for inclusion. Seven studies (319 BD and 43 MDD patients), including one RCT (n = 173), three prospective (n = 105), and three retrospective (n = 84) studies, met the study criteria with a study duration range from 8 to 60.9 weeks. The mean age of this pooled data is 14.6 ± 2.0 years. LAM daily dosage varied from 12.5 to 391.3 mg/day among the studies. In an important finding, the RCT reported favorable outcomes with LAM (HR = 0.46; p = 0.02) in 13- to 17-year-old age group as compared with 10- to 12-year-old age group (HR = 0.93; p = 0.88). In addition, time to occurrence of a bipolar event trended toward favoring LAM over placebo. All the studies identified LAM as an effective and safe drug in PMDs especially, BDs. Overall, LAM was well tolerated with no major significant side effects and no cases of Stevens-Johnson syndrome.Most studies suggested that LAM was safe and effective in pediatric patients with mood disorders. However, the data regarding the therapeutic range for LAM are lacking. Based on the data, there is inconsistent evidence to make conclusive recommendations on therapeutic LAM dosage for mood improvement in the pediatric population. Further studies including larger sample sizes are required to address this relevant clinical question.
Databáze: OpenAIRE
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