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NEUROLOGY 2006;67:1297-1299
© 2006 American Academy of Neurology
Brief Communications

Valproate effects on kinetics of lamotrigine in pregnancy and treatment with oral contraceptives

T. Tomson, MD, PhD, G. Luef, MD, PhD, A. Sabers, MD, S. Pittschieler, MD and I. Öhman, MD

From the Department of Clinical Neuroscience (T.T.) and Department of Clinical Pharmacology (I.Ö.), Karolinska Institutet, Stockholm, Sweden; Department of Neurology, Medical University Innsbruck, Innsbruck, Austria (G.L., S.P.); and Department of Neurology, Glostrup University Hospital, Glostrup, Denmark (A.S.).

Address correspondence and reprint requests to Dr. Torbjörn Tomson, Department of Neurology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden; e-mail: torbjorn.tomson{at}karolinska.se

In eight women treated with lamotrigine monotherapy, the lamotrigine dose/plasma concentration (D/C) ratio increased by 295% from baseline outside pregnancy to midgestation, whereas in six women treated with lamotrigine in combination with valproate, the increase was only 60%. No difference in lamotrigine D/C ratio was found between users and nonusers of oral contraceptives comedicated with valproate. Valproate seems to reduce the induction of lamotrigine metabolism associated with pregnancy or use of contraceptives.

Disclosure: This study was supported by a research grant from GlaxoSmithKline (Dr. Tomson). The sponsor has had no influence on design, conduct of study, collection, management, analysis and interpretation of data or the preparation or approval of the manuscript. The sponsor has, however, been given an opportunity to read the manuscript. Dr. Öhman was a recipient of the GlaxoSmithKline stipend for clinical epilepsy research in Sweden in 2000 and has received honoraria from GlaxoSmithKline not exceeding USD 10,000. Dr. Sabers has received honoraria from GlaxoSmithKline not exceeding USD 10,000. Drs. Luef and Pittschieler have received a research grant from GlaxoSmithKline.

Received December 19, 2005. Accepted in final form June 21, 2006.






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