ArticleThe American journal of psychiatry2013
Lamotrigine dosing for pregnant patients with bipolar disorder.
Article in The American journal of psychiatry, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 32 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Pharmacokinetics of Lamotrigine in Pregnant and Postpartum Women With Bipolar Disorder
A Pilot Study of Prophylactic Management of Lamotrigine for Bipolar Disorder in Pregnant Women
Who cites it
32 citing papers in PubMed, 4 syntheses or guidelines pooled it, 174 citations in OpenAlex.
- Transfer of anticonvulsants and lithium into amniotic fluid, umbilical cord blood & breast milk: A systematic review & combined analysis.Progress in neuro-psychopharmacology & biological psychiatry · 2023Pooled it
- [Use of antiepileptic drugs during breastfeeding : What do we tell the mother?]Der Nervenarzt · 2018Pooled it
- Pregnancy-Associated Changes in Pharmacokinetics: A Systematic Review.PLoS medicine · 2016Pooled it
- Bipolar disorder in pregnancy and childbirth: a systematic review of outcomes.BMC pregnancy and childbirth · 2016Pooled it
- Review
- Mechanisms of altered hepatic drug disposition during pregnancy: small molecules.Expert opinion on drug metabolism & toxicology · 2025Review
- Dosing Optimization of Lamotrigine in Peripregnancy Epilepsy Through PopPK Modelling and Simulation.Drug design, development and therapy · 2025Article
- Reproductive Psychiatry: Postpartum Depression is Only the Tip of the Iceberg.Focus (American Psychiatric Publishing) · 2024Article
- Striking the Balance: Bipolar Disorder in the Perinatal Period.Focus (American Psychiatric Publishing) · 2024Review
- Treating Bipolar Disorder in Primary Care: Diagnosis, Pharmacology, and Management.International journal of general medicine · 2022Article
- Lack of psychotropic medication changes among mood disordered women across the peripartum period.Human psychopharmacology · 2021Article
- Efficacy and safety of lamotrigine in the treatment of bipolar disorder across the lifespan: a systematic review.Therapeutic advances in psychopharmacology · 2021Review
- Drugs in pregnancy: Pharmacologic and physiologic changes that affect clinical care.Seminars in perinatology · 2020Review
- Psychotropic Treatment During Pregnancy: Research Synthesis and Clinical Care Principles.Journal of women's health (2002) · 2020Review
- Psychopharmacological Decision Making in Bipolar Disorder During Pregnancy and Lactation: A Case-by-Case Approach to Using Current Evidence.Focus (American Psychiatric Publishing) · 2019Review
- Pharmacokinetic changes and therapeutic drug monitoring of lamotrigine during pregnancy.Brain and behavior · 2019Article
- Treatment of Peripartum Bipolar Disorder.Obstetrics and gynecology clinics of North America · 2018Review
- Quetiapine Dose Adjustments in Pregnant and Postpartum Women With Bipolar Disorder.Journal of clinical psychopharmacology · 2018Observational
- Lamotrigine-Valproic Acid Interaction Leading to Stevens-Johnson Syndrome.Case reports in medicine · 2018Article
- Medication management of bipolar disorder during the reproductive years.The mental health clinician · 2017Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
objectiveLittle information is available on the need for dosage changes for lamotrigine in pregnant women with bipolar disorder. The authors present new data on serial serum levels of lamotrigine in pregnant patients on lamotrigine monotherapy. They also review the epilepsy literature on use of lamotrigine during pregnancy.
methodLamotrigine serum samples were obtained from eight mother-infant pairs at different time points during pregnancy and the postpartum period.
resultsAll of the women were taking lamotrigine throughout pregnancy. Serum-level-to-dose ratios were lower during pregnancy than the postpartum period. Lamotrigine was taken once daily in doses ranging from 100 mg to 300 mg. Three patients had an increase of 50 mg to their daily dose across pregnancy. The change in serum lamotrigine levels in the postpartum period ranged from a 30% decrease to a 640% increase compared with the first level obtained during pregnancy. Level-to-dose ratios obtained within 4 weeks after delivery reflected a mean level 402% greater than the baseline level during gestation. Compared with the third trimester, lamotrigine serum concentration increased an average of 154% within 5 weeks after delivery. The most dramatic increase in lamotrigine serum level early after delivery occurred at 1.5 weeks. The mean infant cord level was 66% of the maternal serum level at delivery. The mean breast-fed infant serum level was 32.5% of the maternal serum levels.
conclusionsThe pattern of lamotrigine changes during pregnancy in these women with bipolar disorder was consistent with that described in the epilepsy literature.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.