Adding lithium to lamotrigine.
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- Lamotrigine is principally metabolised by UDP-glucuronosyltransferases.
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- Lithium is eliminated by the kidney for about 95%. Changes in the rate of excretion can cause unwanted effects.
- This combination of drugs may be rational, but more data is needed..
- Lamotrigine does not cause a significant change in the pharmacokinetics of lithium. Start lithium according to the general dosing advice. 
- Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects.
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