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Mood disorders in young people have increasingly been recognized as a neglected definition in young people have hindered case findings and the development of treatment evaluation strategies. In addition, there is evidence that younger patients suffer from mixed disorders, rapid cycling and less distinct phenomenology. Each of these characteristics has been associated with a lack of response to traditional mood stabilisers, like lithium. The use of valproate as the first line has now been recommended by a number of authors, although the evidence for its efficacy in this age group is limited. More recently, the possibility of using other anticonvulsants, such as lamotrigine, has emerged within the adult literature in a clinical case sample and based on acute inpatient treatment. There is an absence of research on the efficacy of lamotrigine in children with bipolar affective disorder. We reviewed, retrospectively, the use of lamotrigine, where valproate on its own or in addition to lithium, had been insufficient to stabilize mood. The study was uncontrolled, retrospective and case based. However, all the children treated had extreme pathology and the results were encouraging. This study raises the possibility of a formal trial of lamotrigine in a randomized controlled methodology against the best current treatment available. Area of research and therapeutic intervention. |
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