The response and behavioral profiles of 19 intellectually impaired adults, aged 17-54 years, following treatment with lamotrigine (LTG) as adjunctive therapy for uncontrolled epilepsy are reported from the Epilepsy Research & Services, Chatswood, Australia. Aggressive behavior and violence were provoked in 9 (47%) patients within less than one month of the introduction of LTG, and 5 required complete withdrawal of the drug. Changes in behavior ranged from shouting, slamming doors, or knocking over furniture to attacks on staff and other residents of the institutions. 
COMMENT. The behavior of intellectually impaired patients with epilepsy should be closely monitored when lamotrigine is used as adjunctive therapy for uncontrolled seizures. Violent aggression may be provoked and may require withdrawal of the drug.