Controlled clinical trials involving bipolar patients have shown that lamotrigine is effective in acute phase treatment of depression and mainly in the prevention of new depressive episodes. We report the case of a bipolar II, rapid cycling patient who used lamotrigine (in monotherapy) during a depressive episode and developed a dysphoric manic episode. This episode resolved soon after discontinuation of the drug and was followed by a new depressive episode. The occurrence of the dysphoric manic episode was much unexpected, based on the clinical data found in the literature, which associate lamotrigine with a very low rate of switch into mania.
Bipolar disorder; depression; therapy; lamotrigine