Lamogin, a phenothiazine antiepileptic, is used to treat certain types of epilepsy and bipolar disorder. It controls epileptic seizures by inhibiting voltage-sensitive sodium channels, which stabilizes neuronal membranes and consequently reduces the release of presynaptic excitatory neurotransmitters like glutamate and aspartate.
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Lamogin is an antiepileptic drug (AED) indicated for:
Epilepsy:
Bipolar Disorder: For patients aged 18 years and older.
The precise mechanism of action of lamotrigine is not entirely understood, but it likely involves cellular activities contributing to its effectiveness across various conditions. Though chemically distinct, lamotrigine's actions are similar to those of phenytoin and carbamazepine. It inhibits voltage-sensitive sodium channels, stabilizing neuronal membranes and modulating the release of presynaptic excitatory neurotransmitters.
Lamotrigine is believed to inhibit sodium currents by selectively binding to inactive sodium channels, thereby suppressing the release of the excitatory amino acid glutamate. This mechanism is likely consistent across both its anticonvulsant and mood-stabilizing effects. Studies have shown lamotrigine's binding to sodium channels like local anesthetics, which may also explain its benefits in certain neuropathic pain states.
Laboratory binding assays have shown lamotrigine has a weak inhibitory effect on the serotonin 5-HT3 receptor and binds weakly to several other receptors, including adenosine, adrenergic, dopamine, GABA, histamine, opioid, muscarinic, and serotonin receptors. An in vivo study suggested that lamotrigine inhibits Cav2.3 (R-type) calcium currents, potentially contributing to its anticonvulsant properties.
Overdose can result in ataxia, nystagmus, seizures (including tonic-clonic seizures), decreased consciousness, coma, and intraventricular conduction delay.
Epilepsy:
Table 1: Escalation Regimen for Patients Older Than 12 Years
Weeks 1 & 2:
Weeks 3 & 4:
Week 5 onward to maintenance:
Usual Maintenance Dose:
Table 2: Escalation Regimen for Patients Aged 2 to 12 Years
Weeks 1 & 2:
Weeks 3 & 4:
Week 5 onward to maintenance:
Usual Maintenance Dose:
Table 3: Initial Weight-Based Dosing Guide for Patients Aged 2 to 12 Years Taking Valproate (Weeks 1 to 4)
Weeks 1 & 2:
Weeks 3 & 4:
Bipolar Disorder:
Table 4: Escalation Regimen for Adults
Weeks 1 & 2:
Weeks 3 & 4:
Week 5:
Week 6:
Week 7:
Store in a dry place, below 25°C, protected from light, and out of reach of children.
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