Mood stabilisers: lamotrigine: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Mood stabilisers: lamotrigine

Sample item

Lamotrigine for bipolar depression is started at a low dose and titrated slowly mainly to reduce the risk of:

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Stevens-Johnson syndrome

Lamotrigine is effective in preventing bipolar depression, but rapid titration, or co-administration with valproate (which doubles its level), increases the risk of a serious rash and SJS. It is not useful for acute mania.

Option by option

  • A. Hyperprolactinaemia

    Hyperprolactinaemia is related to antipsychotics.

  • B. Stevens-Johnson syndrome (correct)

    Correct. Slow titration reduces the chance of serious rash and SJS.

  • C. Agranulocytosis

    Agranulocytosis is the classic concern with clozapine and carbamazepine.

  • D. Hepatic failure

    Hepatic failure is a concern with valproate.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is B, Stevens-Johnson syndrome. Lamotrigine is effective in preventing bipolar depression, but rapid titration, or co-administration with valproate (which doubles its level), increases the risk of a serious rash and SJS.

Why is "Hyperprolactinaemia" not the answer?

Hyperprolactinaemia is related to antipsychotics.

Why is "Agranulocytosis" not the answer?

Agranulocytosis is the classic concern with clozapine and carbamazepine.

Why is "Hepatic failure" not the answer?

Hepatic failure is a concern with valproate.

What concept does this question test?

It tests Mood stabilisers: lamotrigine in Psychiatry. It is not useful for acute mania.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Mood stabilisers: lamotrigine?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.