A Holistic Review of Lamotrigine: Pharmacological Properties, Therapeutic Applications, and Potential Toxicity

Lamotrigine is a phenyltriazine derivative widely used as an anticonvulsant and mood stabilizer for the management of epilepsy and bipolar disorder. It acts primarily by inhibiting voltage-gated sodium channels, thereby reducing excessive neuronal excitability and suppressing the release of excitatory neurotransmitters such as glutamate and aspartate. Lamotrigine undergoes hepatic metabolism mainly through glucuronidation, producing inactive metabolites excreted in urine. Genetic variability in drug-metabolizing enzymes may influence its plasma concentration and therapeutic response. This review comprehensively summarizes the pharmacokinetic and pharmacodynamic properties of lamotrigine, including its absorption, distribution, metabolism, and excretion, along with its clinical applications and toxicity profile. Understanding these aspects is essential for optimizing therapeutic efficacy, minimizing adverse effects, and supporting individualized treatment strategies.