OPEN TRIAL OF LAMOTRIGINE IN THE TREATMENT OF SELF-INJURIOUS-BEHAVIORIN AN ADOLESCENT WITH PROFOUND MENTAL-RETARDATION

This single case reports an open trial of lamotrigine in the treatment of self-injurious behavior (SIE) and epilepsy in an IS-year-old femal e diagnosed with generalized seizure disorder, stereotypic movement di sorder, and compulsive SIE in the context of profound mental retardati on, Animal models of SIB suggest that the glutamate neurotransmitter s ystems, involved in the generation of epileptic seizures, may also hav e a role in the pathophysiology of SIE. Data suggesting that lamotrigi ne may decrease glutamate release encouraged an empirical trial of lam otrigine for treatment of SIE. After 4 weeks of treatment of lamotrigi ne 200 mg daily, decreases in agitation and fearfulness were clinicall y observed, along with a 50% reduction in the frequency of SIB as meas ured by standardized scales, Good seizure control was maintained throu ghout the trial, No significant adverse effects were observed, Positiv e effects persisted at I-year follow-up, Symptoms of stereotypic movem ent disorder appeared unchanged, Because these findings are preliminar y, no clinical recommendations for the treatment of SIE with lamotrigi ne can be made until controlled studies have been completed.