Correlation of Lamotrigine Concentrations between Serum and Saliva

Melody Ryan, Shellee A. Grim, Michael V. Miles, Peter H. Tang, Toufic A. Fakhoury, Richard H. Strawsburg, Ton J. DeGrauw, Robert J. Baumann

Research output: Contribution to journalArticlepeer-review

32 Scopus citations


Study Objective. To compare the relationship between serum and salivary concentrations of lamotrigine in pediatric and adult epilepsy populations. Design. Paired-sample pharmacokinetic study. Setting. University neurology clinic. Patients. Thirty-seven patients with epilepsy, aged 2-60 years, who were taking lamotrigine and whose physicians had ordered a lamotrigine serum concentration. Measurements and Main Results. Patients spit a minimum of 0.25 ml into a cup to provide saliva samples. Blood samples were obtained by phlebotomy. Serum and salivary lamotrigine concentrations were determined by high-performance liquid chromatography. Linear regression analysis was used to evaluate correlations. Six patients' results were omitted due to the lack of a serum or saliva specimen or clearly erroneous results, leaving 31 patients for analysis. There was a strong correlation between the serum results reported by two reference laboratories (coefficient of correlation [r] = 0.988). The correlations between salivary and serum lamotrigine concentrations were similar for reference laboratory A (r = 0.81) and reference laboratory B (r = 0.84). Saliva:serum concentration ratios ranged from 0.41-1.26 (mean ± SD 0.62 ± 0.19) for reference laboratory A and from 0.40-1.19 ((mean ± SD 0.64 ± 0.18) for reference laboratory B. Conclusion. There is a good correlation between salivary and serum concentrations for lamotrigine. However, there is wide interpatient variability in the saliva:serum ratio. The data suggest that salivary monitoring may play a role in the monitoring of lamotrigine for adult and pediatric patients.

Original languageEnglish
Pages (from-to)1550-1557
Number of pages8
Issue number12 I
StatePublished - Dec 2003


  • Lamotrigine
  • Pharmacokinetics
  • Salivary concentration
  • Therapeutic drug monitoring

ASJC Scopus subject areas

  • Pharmacology (medical)


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