Abstract
We report three patients with epilepsy in whom lamotrigine was effective for preventing postictal psychosis. These cases suggest that lamotrigine prevents postictal psychosis. All three patients had been diagnosed with temporal lobe epilepsy, and developed postictal psychosis 17 to 27 years after onset of epilepsy. The seizure type was complex partial seizure in all patients, and all patients had at least one seizure per month despite receiving a sufficient dose of antiepileptic drugs. Although the patients had previously experienced at least two to five episodes of psychosis, these episodes did not recur during the 10- to 12-month period following lamotrigine administration. As for seizure frequency, cluster seizures in one patient disappeared and seizure frequency in two patients decreased from once weekly to once monthly following lamotrigine administration. This disappearance of cluster seizures and decrease in seizure frequency might lead to prevention of relapse of postictal psychosis. In general, lamotrigine has a low frequency of side effects that induce psychotic symptoms. Based on these findings, lamotrigine may be a useful antiepileptic drug for preventing postictal psychosis.
