
Is Immune Suppression From Lamotrigine Reversible If The Drug Is Stopped? Why Did I Become Neutropenic While Taking Depakote?

Thank you for sending your question.
Your question is a good one and I will work on providing you with some information and recommendations regarding the problems you are experiencing.
Lamotrigine which is commonly used for the treatment of epilepsy and bipolar disorder can rarely cause agranulocytosis. However there are no confirmed reports of Lamotrigine causing immunoglobulin deficiency. I think your bone marrow is very sensitive and you have drug induced bone marrow suppression.
Low immunoglobulins in you could be induced by Lamotrigine alone or due to combined effect of other drugs with Lamotrigine. As we do not have any parameter or test to see which is causing problem in you, tapering and stopping Lamotrigine would be a good idea in you. If your globulin levels improve we can probably say it is Lamotrigine induced.
My recommendation would be for you to see your psychiatrist and then try tapering the medicine slowly. Abruptly stopping Lamotrigine is not good. Once you stop Lamotrigine in 2 weeks time we should see your immunoglobulins going up. You need to talk to your psychiatrist for an alternate medicine to Lamotrigine for your Bipolar disorder.
I thank you again for submitting your question. I hope you find my response to be both helpful and adequate.
If you have any additional concerns regarding your question I would be happy to address them.
Sincerely,
Dr Shiva Kumar R
Consultant Neurologist & Epileptologist.

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