Lamotrigine may be associated with non-dangerous QRS widening
In this review, researchers investigated the effect lamotrigine may have on cardiac conduction and risk of sudden cardiac death (SCD) in patients with and without cardiovascular disease due to the recent warning by the Food and Drug Administration (FDA) concerning lamotrigine’s arrhythmogenicity.
After reviewing 8 randomized controlled trials, 9 nonrandomized observational studies, and 24 case reports with >3054 total participants, of which >1606 used lamotrigine, researchers concluded that there isn’t enough evidence “to support the breadth of the FDA warning concerning lamotrigine’s cardiac risk.”In a single randomized trial consisting of older patients, there was an average QRS increase of 3.5 +/- 13.1 ms. Of the case reports, 13 documented QRS widening, 6 Brugada syndrome, 1 QTc prolongation, and 2 SCD.
Restrepo JA, MacLean R, Celano CM, et al. The assessment of cardiac risk in patients taking lamotrigine; a systematic review. Gen Hosp Psychiatry. 2022;78:14-27. doi: 10.1016/j.genhosppsych.2022.06.004. Epub ahead of print. PMID: 35763920.