bipolar depression
2 interactions related to bipolar depression
lamotrigine + folate
In a randomized controlled trial of bipolar depression (CEQUEL), adding folic acid to lamotrigine appeared to blunt lamotrigine's antidepressant benefit, an effect seen mainly in people carrying the COMT Met allele. The interaction is pharmacodynamic, not pharmacokinetic, so lamotrigine blood levels stay unchanged. The exact mechanism is not established, and the signal is limited to bipolar depression rather than epilepsy.
grapefruit + lurasidone
Lurasidone is metabolized almost entirely by the CYP3A4 enzyme, which makes it highly sensitive to CYP3A4 inhibitors. The FDA-approved Latuda prescribing information states that grapefruit and grapefruit juice should be avoided in patients taking lurasidone, because they inhibit CYP3A4 and can raise lurasidone concentrations.