Q:  Lamotrigine & Nodules?

I am a psych NP in Portland.  I have two female patients fairly recently started on lamotragine  and happy with clinical results.  Both have developed painful nodules on their hands.  They are both in their 50's and the one who has been seen by her internist has been told she has no signs of arthritis.  Both have elected to stop the medication and we are waiting to see if the nodules change.  I have not seen them yet but the internist involved is quite puzzled as am I.  Do you have any thoughts about this? 

Hello Mary Lou -- 
Haven't seen or heard of this one. As you have probably done yourself, I searched lamotrigine arthritis in Google and PUB MED; and lamotrigine nodules in Google; and found nothing like this. Not a perfect search, of course. You may also already have tried the lamotrigine rep (call me, 541 829 9319 if you need her number) to ask the medical science people at GlaxoSmithKline to follow up on this; they'll likely file it as a "adverse event" just because it's being reported, but if there are other such cases you might hear more from them. If not, yet this is truly associated with lamotrigine, then you'd want those cases on file so that somebody else's patient will know this has been reported. 

Jim Phelps

Published February, 2006