Hypomania with Low-Dose Lamotrigine Suggests it Really is an Antidepressant

Depression predominates over any other mood phases in bipolar I disorder, and treatment options remain sparse. Lamotrigine, an anticonvulsant used for the prevention and treatment of bipolar depression, has been reported to induce hypomanic and manic switches. Its multimodal mechanism of action may provide an explanation for its propensity to induce mood switches. The authors report a case of hypomania developing briefly after the introduction of very low-dose adjunctive lamotrigine for the treatment of bipolar depression and review proposed mechanisms of action.