Lamotrigine for ADHD
Lamotrigine is a 2nd generation antiepileptic drug.
Chemical name: 3,5-Diamino-6-(2,3-dichlorophenyl)-1,2,4-triazine
Molecular formula: C9H7Cl2N5
Pathways of action of lamotrigine:1
- Blockade of voltage-dependent sodium and calcium channels
- This prevents the release of glutamate and aspartate
Higher doses of lamotrigine caused in vitro2
- SERT expression reduced
- CCCTC binding factor expression increased
Indications:1
- Epilepsy
- focal seizures
- generalized seizures
- Seizure prevention for alcohol withdrawal
- depressive episodes in bipolar Disorder
- Huntington’s disease
- Parkinson’s disease
Lamotrigine has not yet been tested for use in ADHD without comorbidity.
Lamotrigine improved ADHD symptoms in 77.5% of adults with ADHD and comorbid bipolar disorder or ADHD and comorbid depression. Worsening was found in 2 out of 40 people with ADHD. The dose was 125.6 ± 47.8 mg.3
Lamotrigine improved ADHD symptoms in 87.1% of children with ADHD and comorbid epilepsy.4
Low-dose lamotrigine was given to children with paroxysmal kinesigenic dyskinesia and comorbid ADHD. After 2 years, there was a significant reduction in ADHD inattention with an average decrease in total subscale scores from 9.04 to 6.24.5
A case study reports a complete remission of impulsive-aggressive seizures in a young woman with ADHD using lamotrigine.6
In epilepsy, both lamotrigine and carbamazepine show positive effects on attention and behavior.78
D’Souza UM, Powell-Smith G, Haddley K, Powell TR, Bubb VJ, Price T, McGuffin P, Quinn JP, Farmer AE (2013): Allele-specific expression of the serotonin transporter and its transcription factors following lamotrigine treatment in vitro. Am J Med Genet B Neuropsychiatr Genet. 2013 Jul;162B(5):474-83. doi: 10.1002/ajmg.b.32178. PMID: 23765727. ↥
Öncü B, Er O, Çolak B, Nutt DJ (2014): Lamotrigine for attention deficit-hyperactivity disorder comorbid with mood disorders: a case series. J Psychopharmacol. 2014 Mar;28(3):282-3. doi: 10.1177/0269881113493365. PMID: 23784736. n = 40 ↥
Han SA, Yang EJ, Song MK, Kim SJ (2017): Effects of lamotrigine on attention-deficit hyperactivity disorder in pediatric epilepsy patients. Korean J Pediatr. 2017 Jun;60(6):189-195. doi: 10.3345/kjp.2017.60.6.189. PMID: 28690646; PMCID: PMC5500387. n = 31 ↥
You DD, Huang YM, Wang XY, Li W, Li F (2024): Long-term low-dose lamotrigine for paroxysmal kinesigenic dyskinesia: a two-year investigation of cognitive function in children. Front Psychiatry. 2024 Mar 11;15:1368289. doi: 10.3389/fpsyt.2024.1368289. PMID: 38528979; PMCID: PMC10961978. n = 25 ↥
Sablaban IM, Sivananthan M (2022): Attention-Deficit Hyperactivity Disorder-Associated Impulsive Aggression Treated With Lamotrigine. Am J Ther. 2022 Nov-Dec 01;29(6):e747-e748. doi: 10.1097/MJT.0000000000001219. PMID: 32769396. ↥
Verrotti A, Moavero R, Panzarino G, Di Paolantonio C, Rizzo R, Curatolo P (2018): The Challenge of Pharmacotherapy in Children and Adolescents with Epilepsy-ADHD Comorbidity. Clin Drug Investig. 2018 Jan;38(1):1-8. doi: 10.1007/s40261-017-0585-1. PMID: 29071470. REVIEW ↥
Schubert R (2005): Attention deficit disorder and epilepsy. Pediatr Neurol. 2005 Jan;32(1):1-10. doi: 10.1016/j.pediatrneurol.2004.06.007. PMID: 15607597. REVIEW ↥