Psychopharmacology and Psychiatry Updates Lamotrigine and the Heart: What You Need to Know
Mar 7, 2025
Dive into the cardiac risks associated with lamotrigine usage and the importance of EKG monitoring. Learn why reducing the drug dose might not lower those risks and could lead to psychiatric issues instead. Explore safe prescribing practices, especially for patients with heart conditions, and hear about alternative strategies for managing these complexities. This insightful conversation emphasizes balancing the benefits of medication with potential cardiac effects, ensuring patient safety every step of the way.
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Patient Anxiety About Cardiac Risks
- A 35-year-old woman with bipolar disorder, stable on lamotrigine, became anxious after reading about cardiac risks online.
- This highlights the challenge of balancing theoretical risks with the benefits of psychiatric stability.
Lamotrigine EKG Monitoring
- For patients without cardiac risk factors, no EKG monitoring is needed for lamotrigine.
- Monitor patients with a history of conduction disorder or ventricular arrhythmia.
EKGs and Alternative Agents
- Consider a baseline and follow-up EKG for patients with conduction disorders or ventricular arrhythmias.
- For patients with a family history of Brugada syndrome, consider alternative agents like valproate or oxcarbazepine.