Q:  Melanin/lamotrigine Binding - New Information?

I was wondering if you had any updates concerning Lamotrigine binding to melanin-containing tissues. I saw that you addressed this question in 2005 with an update, but are you aware of any new information? What are the consequences of melanin/lamictal binding?


Dear Mr. G' -- 

Right, let's have a look again at that issue. I went to the article abstract at Pub Med and looked for related articles. The National Library of Medicine has a system for this, although it is not perfect. Nothing more recent than that 2005 article.

Secondly, in reviewing everything I can find on Google, I'm struck by the similarity in language used in describing the observation that "lamotrigine binds to melanin-rich tissues". It looks to me like virtually every source I can find on the first page of Google links is referring to the same original source of information, which may be the Kaplan and Sadock textbook, or perhaps the manufacturer. The point is, this issue does not appear to be coming from multiple sources of information, but rather just 1 -- by my very rough estimate.

Third, this medication has been in use for over 15 years in the treatment of people with seizures. Have some sort of vision problem was going to develop from years and years of exposure, anyone starting lamotrigine now has the benefit of those patients out ahead of them pioneering. Perhaps there is some bad outcome we are going to learn about that takes 20 years to emerge (although that possibility applies to a great many medications), but so far things look okay.

Dr. Phelps