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lamictal pediatric dosages bipolar


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My 9 year old has bipolar and she takes 50mg lamictal (she's about 60 lbs). She had greatly improved. she was sobbing and tantruming daily before she started. But, lately she's been pretty aggressive with her younger brother who is 6 years old.

She hits, bites, kicks him with little provocation. We sat them down last night and told them they aren't allowed to hurt anyone (she bangs her head against the wall sometimes, so I told her that includes herself). I also told my son he needs to let her have some space and not bother her when she wants to be left alone. The next time we're going to seperate them to their rooms. Then let them each tell their side of the story and try to come to a solution on their own. This is my therapists suggestion.

I've been so happy about how well she's doing that I've been downplaying this somewhat to her pdoc. I'll bring it up at the next appointment.

Are there suggested dosages for lamictal for children? How does her dose fit?

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She may be have a breakthrough episode. If it doesn't resolve or gets worse I recommend call her doctor.

The PI sheet for Lamital is less than clear. It does not differentiate between adult/peds dosing. THe suggested range is 25 -200mg, if there are no med interactions like Valproate. As a crosscheck, the epilepsy dosing guide says for a child under 12yo, weight 60lbs, dosage is 8mg/day.

However, docs do vary widely in how much they rx based on experience.

Here is the PI sheet summary: http://www.rxlist.com/cgi/generic/lamotrigine_ids.htm

a.m.

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She may be have a breakthrough episode. If it doesn't resolve or gets worse I recommend call her doctor.

The PI sheet for Lamital is less than clear. It does not differentiate between adult/peds dosing. THe suggested range is 25 -200mg, if there are no med interactions like Valproate. As a crosscheck, the epilepsy dosing guide says for a child under 12yo, weight 60lbs, dosage is 8mg/day.

However, docs do vary widely in how much they rx based on experience.

Here is the PI sheet summary: [link=http://www.rxlist.com/cgi/generic/lamotrigine_ids.htm"'>http://www.rxlist.com/cgi/generic/lamotrigine_ids.htm" target="_blank]http://www.rxlist.com/cgi/generic/lamotrigine_ids.htm[/link]

a.m.

Thank you!

8mg sounds really low

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Not that I've looked for anything about it yet, since I just woke up, but don't they usually do trials based on mg/kg (med per body weight) dosing to find out whether it works or the effective range? And I think someone was talking recently about having blood levels done for Lamictal to see if it was still the same/in the right range for them. Both of those things suggest to me that there's probably at least a rough guideline for it out there that could be applied in this case.

Also, unless it works significantly differently in kids, I'm surprised 8mg/day even does anything at all for seizures. Triple the weight to get to adult size, and then even allow for a different proportion of brain-to-rest-of-body volume and arbitrarily double it again, and you're still only at 50mg/day, which is a fraction of the low end of the therapeutic range for adults for seizures (which is generally considered to start around 200 or 300mg/day and go up from there). And the dosing is usually higher for seizures than mood disorders, so I'm amazed that little would do anything to anyone (at least if they're not simultaneously on Depakote or something that similarly screws with the levels). Heh.

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