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Q: Lamictal & Arrhythmia
I was prescribed Lamictal for a trial diagnosis of Bipolar 2 disorder (rapid
cycling - depression & severe anxiety). Lamictal was a wonder drug
for my mood. For the first time in many years I felt calm and "normal."
However, as we arrived at a therapeutic dose (100 mg), I began having an
irregular heart beat. It persisted and I saw a cardiologist who diagnosed
me with atrial fibrillation. He and my psychiatrist do not think that
Lamictal is associated with the rapid heart beat. I got off of Lamictal because
I wasn't convinced that there was no correlation and indeed the heart beat
returned to normal - for several weeks. Then the arrythmia returned but
was less severe. My anxiety and mood swings also returned so I decided to
get back on the Lamictal. However, as i increase the dose (I'm now at 50 mg) the
arrythmia is getting more and more severe. My heart beats very rapidly and
I lose my breath and all energy - all of this despite the medication prescribed
by my cardiologist (Verapamil). Is there any know association between
Lamictal and arrythmias? Is it possible? Any suggestions would be greatly
appreciated. Thank you very much.
Michael
Dear Michael --
Haven't heard of this. So, searching
PUB MED with "lamotrigine arrhythmia",
we find one article from Switzerland in which a research team studied the
cardiologic effects of lamotrigine.
They found none, basically, though this was a tiny study.
However, the connection seems fairly direct in your case given your on-off-on
test results. I'm sorry to say I have nothing to recommend. I wonder if another
cardiologist might offer some more aggressive means of controlling a'fib, if you
wanted to explore ways to stay on lamotrigine? There are some " ablation"
techniques which have very high success
rates in spontaneous atrial fibrillation: a little scary, but perhaps worth
looking into if the response to lamotrigine was that good (some people would
consider the ablation treatment just to limit the effects of a'fib' alone).
Dr. Phelps
Published September, 2004
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