Penggunaan Lamotrigine Untuk Gangguan Bipolar

Oleh :

dr. Irwan Supriyanto PhD SpKJ

Lamotrigine adalah obat golongan antikonvulsan yang juga digunakan sebagai mood stabilizer dalam manajemen gangguan bipolar. Gangguan bipolar adalah suatu kelainan psikiatri yang melibatkan episode depresi dan/atau mania. Manajemen gangguan bipolar bertujuan untuk menangani gejala-gejala fase akut, baik episode manik, depresi, atau campuran. Manajemen juga ditujukkan untuk terapi rumatan jangka panjang yang difokuskan pada pencegahan perubahan polaritas dan rekurensi, serta pencegahan bunuh diri.[1–3]

Pemilihan obat dalam penanganan kasus gangguan bipolar didasarkan pada episode yang dialami oleh pasien, serta profil efek samping dan keamanan obat bagi pasien. Lamotrigine telah dilaporkan menghasilkan efikasi yang baik dan menurunkan risiko rekurensi lebih baik daripada plasebo dalam penanganan kasus gangguan bipolar.[2,3]

Ulasan Singkat Penanganan Gangguan Bipolar

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Referensi

1. Hashimoto Y, Kotake K, Watanabe N, Fujiwara T, Sakamoto S. Lamotrigine in the maintenance treatment of bipolar disorder. Cochrane Database of Systematic Reviews 2021 http://doi.wiley.com/10.1002/14651858.CD013575.pub2
2. Joshi A, Bow A, Agius M. Pharmacological therapies in bipolar disorder: A review of current treatment options. Psychiatr Danub, 2019;31:595–603.
3. Lähteenvuo M, Tanskanen A, Taipale H, Hoti F, Vattulainen P, Vieta E, et al. Real-world Effectiveness of Pharmacologic Treatments for the Prevention of Rehospitalization in a Finnish Nationwide Cohort of Patients With Bipolar Disorder. JAMA Psychiatry 2018;75:347.
4. Besag FMC, Vasey MJ, Sharma AN, Lam ICH. Efficacy and safety of lamotrigine in the treatment of bipolar disorder across the lifespan: a systematic review. Therapeutic Advances in Psychopharmacology 2021;11:204512532110458.
5. Woo YS, Yoon B-H, Song J-H, Seo JS, Nam B, Lee K, et al. Clinical correlates associated with the long-term response of bipolar disorder patients to lithium, valproate or lamotrigine: A retrospective study. PLoS ONE 2020;15:e0227217.
6. Mufson JM. Lamotrigine: Pharmacology, Clinical Utility, and New Safety Concerns. American Journal of Psychiatry Residents’ Journal 2018;13:2–4.
7. Watanabe Y, Hongo S. Long-term efficacy and safety of lamotrigine for all types of bipolar disorder. NDT, 2017. Volume 13:843–54.
8. Yee CS, Vázquez GH, Hawken ER, Biorac A, Tondo L, Baldessarini RJ. Long-Term Treatment of Bipolar Disorder with Valproate: Updated Systematic Review and Meta-analyses. Harvard Review of Psychiatry 2021;29:188–95.
9. Pan P-Y, Lee M-S, Lo M-C, Yang E-L, Yeh C-B. Olanzapine is superior to lamotrigine in the prevention of bipolar depression: a naturalistic observational study. BMC Psychiatry 2014;14:145.
10. Geddes JR, Gardiner A, Rendell J, Voysey M, Tunbridge E, Hinds C, et al. Comparative evaluation of quetiapine plus lamotrigine combination versus quetiapine monotherapy (and folic acid versus placebo) in bipolar depression (CEQUEL): a 2 × 2 factorial randomised trial. Lancet Psychiatry 2016;3:31–9.
11. Carlson BX, Ketter TA, Sun W, Timko K, McQuade RD, Sanchez R, et al. Aripiprazole in combination with lamotrigine for the long-term treatment of patients with bipolar I disorder (manic or mixed): a randomized, multicenter, double-blind study (CN138-392). Bipolar Disorders 2012;14:41–53. [https://pubmed.ncbi.nlm.nih.gov/22329471/]