From the Guidelines

Lamotrigine (Lamictal) is indicated for the treatment of bipolar depression in adults and adolescents.

The FDA has approved lamotrigine for maintenance therapy in adults with bipolar disorder 1.
There is evidence to support the use of lamotrigine for bipolar depression in adolescents, as shown in an open-label trial by Chang et al. (2006) 1.
Lamotrigine is not approved for acute mania, but it can be used as an adjunctive therapy for the treatment of bipolar disorder.
The use of lamotrigine in children and adolescents is based on adult literature and clinical experience, as there are limited studies on its efficacy and safety in this population 1.
Clinicians should exercise caution when prescribing lamotrigine, especially in combination with other medications, due to the potential for adverse effects and interactions.

The diagnosis of bipolar disorder should be well established before initiating treatment with lamotrigine.
Patients should be closely monitored for signs of mood destabilization, suicidal ideation, or other adverse effects.
The use of lamotrigine in children and adolescents requires careful consideration of the potential benefits and risks, as well as ongoing monitoring and evaluation.

From the Research

Lamotrigine is indicated for the treatment of partial seizures, secondarily generalized tonic-clonic seizures, and idiopathic (primary) generalized epilepsy 2
It is also effective as an adjunctive therapy in adults with refractory partial epilepsy, reducing total seizure frequency and producing improvement in patients 2
In children with refractory multiple seizure types, lamotrigine has proved effective as add-on therapy, with approximately 40% of patients showing > or = 50% reductions in seizure frequency 2
Lamotrigine is indicated for the prevention of mood episodes in adult patients with bipolar I disorder, significantly delaying time to intervention for any new mood episode 3, 4
It has also shown efficacy in the acute treatment of patients with bipolar depression, but has not demonstrated efficacy in the treatment of acute mania 3, 4
Other potential indications for lamotrigine include treatment-resistant schizophrenia, treatment-resistant obsessive-compulsive disorder, posttraumatic stress disorder, depersonalization disorder, and affective dysregulation and behavioral dyscontrol domains of borderline personality disorder 5

The dosage of lamotrigine is titrated over a 6-week period to 200 mg/day to minimize the incidence of serious rash 3, 4
Adjustments to the initial and target dosages are required if coadministered with valproate semisodium or carbamazepine 3, 4

The most common adverse events associated with lamotrigine are primarily neurological, gastrointestinal, and dermatological 2
Maculopapular or erythematous skin rash, occasionally severe, occurs in approximately 10% of patients and is the most common cause of treatment withdrawal 2
The risk of rash can be minimized through adoption of a low, slow dosage titration schedule on initiating therapy 2