Consult specialist advice. Managing bipolar depression in adults in secondary care. Psychological interventions. adults with bipolar depression should be offered: …The target serum concentration is 50 to 125 mcg/mL. The maximum daily dose is 35 to 60 mg/day. Valproate levels are drawn approximately 12 hours after the last dose (12-hour serum trough level), and generally… DESCRIPTION. LAMICTAL (lamotrigine), an AED of the phenyltriazine class, is chemically unrelated to existing AEDs. Lamotrigine's chemical name is 3,5-diamino-6-(2,3-dichlorophenyl)-as-triazine, its molecular formula is C 9 H 7 N 5 Cl 2, and its molecular weight is 256.09. Lamotrigine Tablets official prescribing information for healthcare professionals. Includes: indications, dosage, adverse reactions, pharmacology and more. a Valproate has been shown to inhibit glucuronidation and decrease the apparent clearance of Lamotrigine [see Drug Interactions (7), Clinical Pharmacology (12.3)]. Valproate has been administered to children as young as 2 years, but data on appropriate dosage based on age are limited. Younger children, especially those receiving concomitant enzyme-inducing anticonvulsants, may need larger maintenance doses to attain target total and unbound serum valproic acid concentrations compared to adults. Treatment for bipolar disorder aims to reduce the severity and number of episodes of depression and mania to allow as normal a life as possible. Sodium Valproate 200mg Gastro-Resistant Tablets are contraindicated in the following situations: • In pregnancy unless there is no suitable alternative treatment (see section 4.4 and 4.6). Summary There is limited evidence that the augmentation of antipsychotics with valproate may be effective for overall response and also for specific symptoms, especially in terms of excitement and aggression. Abstract. We report a rare case of hallucinations in a patient with bipolar affective disorder BAD without any history of psychosis or epilepsy following the introduction of lamotrigine as an add-on medication to her current treatment with lithium carbonate.