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Background: Our aim was to evaluate the effectiveness, safety, and tolerability of adjunctive lamotrigine in the treatment of adolescents with bipolar disorder.

Method: We evaluated all patients under age 18 with Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) bipolar disorder in our outpatient clinic treated with lamotrigine, using the Clinical Global Impression (CGI) scale. We rated response with the CGI—Improvement (CGI-I) scale.

Results: Five patients (mean age = 15.5 ± 1.8 years; range = 14–17), 1 male and 4 females, were included. One patient (20%) had bipolar I disorder, 1 (20%) had bipolar II disorder, and 3 (60%) had bipolar disorder not otherwise specified (NOS). The polarity of the episode at baseline was depressive in all patients. The mean lamotrigine dose was 100 ± 87.5 mg/day (1.67 ± 1.39 mg/kg/day). The mean duration of treatment was 28 ± 28 weeks. CGI significantly improved from 5 at baseline to 3 ± 1 at endpoint (p = 0.011). Improvement was marked or moderate in 4 patients (80%) and minimal in 1 patient (20%). One patient referred to dizziness, and there were no reports of increased cycling, worsening of mania, or skin rash.

Conclusions: This open, retrospective chart review suggests that lamotrigine may be effective and well tolerated as an adjunctive treatment in adolescents with bipolar disorder. Controlled trials are needed.