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Objective: Lamotrigine is found to be effective in continuation treatment of bipolar disorder’s depressive phase. Some fatal, hepatic side effects were reported due to lamotrigine treatment. A laboratory study on rats showed significant increase of liver enzymes, SGOT, SGPT and Total Billirubin levels which might also be valid for human subjects. In this study we aimed to evaluate retrospectively the effect of lamotrigine on liver functioning. Method: Patients between 18–60 years, who applied to Gaziantep University fiahinbey Research Hospital between 30 November 2006 and 28 February 2007 and diagnosed as bipolar disorder, recent episode depressive or major depressive disorder according to DSM IV were included in the study. All patients received lamotrigine as prophylactic treatment for mood disorders. After inclusion into the study medical records of the patients were retrospectively evaluated. The serum levels of several liver function tests (ie. SGOT, SGPT and Total Bilirubin) before treatment and 1st or 3 rd month after the initation of the treatment were taken into consideration. Missing values were estimated by series means method. Results: There was no significant difference betwen initial and late values. There was no correlation between initial and late dosage, and levels. After treatment the SGOT, SGPT levels of only two patients were elevated. Discussion: From the fact that there was no significant difference between groups but significant elevation in transaminase levels of two patients lead us to think that routine montioring of liver functioning throughout the treatment may not be essential, but a cross-sectional test should be beneficial. Results should be considered carefully as this is the one of the first studies evaluating the effect in men of lamotrigine on liver enzymes in the short term.
Duygudurum bozukluklarında lamotrijin tedavisinin karaciğer enzimlerine etkisi: Geriye dönük bir çalışma
Amaç: Lamotrijin’nin bipolar bozuklu¤un depresif ataklar›n›n sürdürüm tedavisinde etkili oldu¤u bulunmufltur. Lamotrijin tedavisine ba¤- l› olarak, baz›s› ölümcül, hepatik yan etkiler rapor edilmifltir. Nitekim s›çanlarda yap›lan bir çal›flma lamotirijin’in karaci¤er enzimlerinden SGOT ve SGPT ile total bilirubin (TB) düzeylerinde anlaml› yükselmelere yol açt›¤› gösterilmifltir. Bu çal›flmam›zda biz geriye dönük olarak lamotrijin’in karaci¤er enzimlerine olan etkisini incelemeyi amaçlad›k. Yöntem: Üç ayl›k bir süre içerisinde Gaziantep Üniversitesi fiahinbey Araflt›rma ve Uygulama Hastanesi’ne baflvurmufl ve lamotrijin tedavisi bafllanm›fl, 18–60 yafl aras› DSM IV’e göre bipolar bozukluk, en son atak depresif veya major depresif bozukluk tan›lar› konmufl hastalar›n t›bbi kay›tlar› ve psikiyatri dosyalar› geriye dönük olarak incelenmifltir. Hastalar›n ola¤an karaci¤er enzim izlemlerinden tedavi öncesi, ilk ay veya 3. ay SGOT ve SGPT düzeyleri ile total bilirubin de¤erleri dikkate al›nm›flt›r. Eksik de¤erler, seri ortalamas› yöntemiyle hesaplanm›flt›r. Bulgular: Hastalar›n bafllang›ç ve son karaci¤er de¤erleri aras›nda anlaml› fark yoktu. Bafllang›ç ve son lamotrijin dozu ile de¤erler aras›nda anlaml› ba¤›nt› yoktu. Ancak iki hastada tedavi sonras› SGOT ve SGPT de¤erleri yükselmiflti. Tart›flma: ‹zlem gruplar› aras›nda anlaml› fark bulunmamas› ancak iki olguda klinik olarak yükselme gözlenmesinden hareketle, tedavi boyunca karaci¤er enzimlerini izlemeye gerek olmad›¤› ama kesitsel olarak bir de¤erlendirmenin yararl› olabilece¤i söylenebilir.