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Type moodstabilizer
Group anticonvulsant
ATC-code N03AX09
PubChem 3878
PubMed Lamotrigine lamotrigine
Kompas (Dutch) Lamotrigine
Wikipedia Lamotrigine
Type moodstabilizer
Group anticonvulsant
ATC-code N03AF01
Medscape Carbamazepine
PubChem 2554
PubMed Carbamazepine carbamazepine
Kompas (Dutch) Carbamazepine
Wikipedia Carbamazepine

Adding carbamazepine to lamotrigine.

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General information
  • Lamotrigine is principally metabolised by UDP-glucuronosyltransferases.
  • Carbamazepine is principally metabolized by CYP3A4, and is a potent inducer of CYP1A2, CYP2C9, CYP3A4 and UDP-glucuronosyltransferases.


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Start carbamazepine
  • Start carbamazepine with a daily dose of 200 mg and increase dose based on serum concentration if necessary. Check lamotrigine effect after 2 weeks of therapy and adapt dose if necessary.[6] [7]
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  • Abrupt stop of carbamazepine can cause serious lamotrigine rash as lamotrigine levels increase.[8]
  • Carbamazepine likely speeds the metabolism of lamotrigine, but the clinical significance is unclear.[9][10]
  • Lamotrigine may increase blood levels of carbamazepine metabolites, which can result in neurotoxicity (data about this are contradictory).[9][10]
  • These two agents have less significant pharmacologic interactions than do lamotrigine and valproate.[9][10]

  1. 1.0 1.1 Farmacotherapeutisch Kompas; Toxicologie (dutch)
  2. 2.0 2.1 Farmacotherapeutisch Kompas - lamotrigine (dutch) Cite error: Invalid <ref> tag; name "ftk" defined multiple times with different content
  3. lamotrigine
  4. WHO Collaborating Centre for Drug Statistics Methodology ATC=N03AF01
  5. KNMP; Informatorium Medicamentorum 2023; Monografie "carbamazepine" (Dutch)
  6. Schalekamp T. et al, Interacties met Psychofarmaca, Stichting Health Base, Houten, 2002.
  7. Interactions between lamotrigine and carbamazepine on
  8. Koch HJ et al. Clinically relevant reduction of lamotrigine concentrations by carbamazepine. J Clin Psychiatry 2005;66:400-1
  9. 9.0 9.1 9.2 Freeman et al. Mood stabilizer Combinations: A Review of Safety and Efficacy. Am J Psychiatry 1998;155:12-21
  10. 10.0 10.1 10.2 Levy RH et al, Metabolic Drug Interactions, Lippincott Williams & Wilkins, Philadelphia, 2000.
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