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A non-randomized study to investigate the effects of the atypical antipsychotic aripiprazole on the steady-state pharmacokinetics of lamotrigine in patients with bipolar I disorder

✍ Scribed by Frank C Schieber; David W Boulton; Alfred H Balch; Robert Croop; Suresh Mallikaarjun; Jeannine Benson; Berit X Carlson


Publisher
John Wiley and Sons
Year
2009
Tongue
English
Weight
135 KB
Volume
24
Category
Article
ISSN
0885-6222

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✦ Synopsis


Abstract

Objective

To determine the effect of aripiprazole on steady‐state pharmacokinetics of lamotrigine in patients with bipolar I disorder who were clinically stable on lamotrigine (100–400 mg/day) for ≥4 weeks.

Methods

In this open‐label study, aripiprazole was administered at 10 mg/day for 3 days, 20 mg/day for 3 days, then 30 mg/day for 8 days. Blood samples were collected on Days –1 and 14 for determination of lamotrigine steady‐state pharmacokinetic parameters. Safety and tolerability were assessed.

Results

Eighteen patients were administered aripiprazole in combination with lamotrigine. Geometric mean (GM) values for lamotrigine maximum plasma concentration were similar for lamotrigine alone (26 ng/mL) and with co‐administered aripiprazole (23 ng/mL). GM values for plasma lamotrigine area under the concentration–time curve (AUCτ) were comparable for lamotrigine alone (434 ng/h/mL) and with co‐administered aripiprazole (394 ng/h/mL). Median T~max~ of lamotrigine alone and combined with aripiprazole was 1.98 and 0.77 h, respectively. No changes to lamotrigine dose‐normalized plasma trough concentrations were observed with co‐administered aripiprazole. Sixteen patients (88.9%) experienced ≥1 adverse event (AE), the most common of which was insomnia (n = 6).

Conclusions

Aripiprazole had no meaningful effect on lamotrigine steady‐state pharmacokinetics in patients with bipolar I disorder. No dosage adjustment of lamotrigine is required and the combination was generally safe and well tolerated. Copyright © 2009 John Wiley & Sons, Ltd.