Section - CAP Smart Takes

03. Lamotrigine’s Efficacy and Safety in Pediatric Mood Disorders

Published on August 1, 2023 Certification expiration date: August 1, 2026

David R. Rosenberg, M.D.

Chair of the Department of Psychiatry & Behavioral Neuroscience - Wayne State University School of Medicine

Key Points

Lamotrigine is well-tolerated and exhibits low-to-moderate efficacy in pediatric mood disorders as either monotherapy or an augmenting agent. However, there is a lack of double-blind, placebo-controlled trials.
Slow-dose titration of lamotrigine can significantly reduce the risk of severe dermatological reactions, like Stevens-Johnson syndrome, which, though rare, can be potentially fatal.

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Greetings, I am David Rosenberg for the Psychopharmacology Institute. In this CAP—or Child and Adolescent Psychiatry—Smart Take, we closely examine lamotrigine’s role in pediatric mood disorders. Lamotrigine presents an appealing treatment option, having demonstrated the ability to inhibit pathological, yet not normal, glutamate release. The primary approved indication for lamotrigine lies within pediatric epilepsy, with a particular focus on Lennox-Gastaut syndrome. Nonetheless, it also emerges as a promising alternative for maintenance treatment of pediatric mood disorders, given its proven safety in pediatric epilepsy, coupled with low-dose initiation and slow-dose titration. Lamotrigine conveys a significant risk of benign rash in pediatric patients with mood disorders; however, the risk of Stevens-Johnson syndrome—which leads to permanently disfiguring or fatal dermatologic reactions—can decrease considerably with slow titration of lamotrigine dose.

In light of the limited options for pediatric mood disorders, high rates of incomplete response, and treatment resistance in pediatric populations, the systematic review

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04. Managing ADHD and Anxiety in Children: A Clinical Guide

Learning Objectives:

Learn effective strategies for evaluating, monitoring, and managing antidepressant-related side effects in young patients.
Understand the impact of age on antidepressant response in patients with major depressive disorder and its implications for clinical practice.
Recognize that lamotrigine appears to be effective in pediatric mood disorders as monotherapy or an augmenting agent.
Recognize that ADHD with comorbid anxiety requires distinct diagnostic and treatment approaches.
Understand the real-world prescribing patterns of OROS-MPH in treating ADHD in children and adolescents.

Original Release Date: August 1, 2023

Review and Re-release Date: March 1, 2024

Expiration Date: August 1, 2026

Expert: David Rosenberg, M.D.

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

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This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.