[Efficacy of lamotrigin in treatment of avoidance / numbing in post-traumatic stress disorders]

Post-traumatic stress disorder [PTSD] is a chronic illness which is difficult to treat; yet, it is a common disorder which is associated with significant morbidity and mortality. The hypothesis that exposure to traumatic events may sensitize or kindle limbic nuclei has led to efforts to treat PTSD with anticonvulsants based on the kindling hypothesis. This double-blind clinical trial assesses clinical response to lamotrigine as a potential treatment. Thirty patients with PTSD were randomly assigned in a double-blind design. They were treated for 3 months with lamotrigine [N=1 5, 150-500 mg/day] as odd-on or placebo [N=15]. The patients were measured in the first visit and at the end of 3 months by clinician administration. PTSD scales [CAPS] paired t-test, and Friedman and Will Coxon were used for data analysis. The mean score of frequency of PTSD criteria in Lamotrigine group in the first visit was 10.1 +/- 2.2 and in placebo group was 12.75 +/- 2.24. The mean score of these criteria in lamotrigin group after treatment period was 9 +/- 2.5 and for placebo group was 12.45 +/- 2.7. The analysis of these sores showed a significant difference in Lamotrigine group and a non significant difference in placebo group. The mean score of Intensity of PTSD criteria in Lamotrigine group in first visit was 9.4 +/- 1 .2 and in placebo group was 9.1 +/- 1-9. The mean score of these criteria in Lamotrigine group after treatment group was 8.4 +/- 2 and for placebo group was 9.1 +/- 2. The analysis of these scores showed a significant difference in lamotrigine group and a non-significant difference in placebo group. In placebo group, the analysis of mean sores of all intensity and frequency of criteria before and after taking placebo showed a non-significant difference. In Lamotrigine group, the analysis of mean scores of intensity and frequency of criteria such as avoidance of thoughts or feelings, avoidances of activities, place, people, inability to recall important aspect of trauma and diminished interest in activities before and after taking lamotrigine showed a significant difference and in other criteria showed a non-significant difference. Comparison of mean of decline in CAPS scores before and after treatment in placebo and lamotrigine group showed a significant difference in the four symptoms in lamotrigine group. Results of the study suggest that lamotrigine is a safe, well tolerated and significant effective treatment for avoidance numbing of PTSD