- What is lamotrigine, and how does it work (mechanism of action)?
- What brand names are available for lamotrigine?
- Is lamotrigine available as a generic drug?
- Do I need a prescription for lamotrigine?
- What are the side effects of lamotrigine?
- What is the dosage for lamotrigine?
- Which drugs or supplements interact with lamotrigine?
- Is lamotrigine safe to take if I'm pregnant or breastfeeding?
- What else should I know about lamotrigine?
What is lamotrigine, and how does it work (mechanism of action)?
Lamotrigine is an oral drug that is used primarily for treating seizures. It is chemically unrelated to other anti-seizure drugs. The precise mechanism by which lamotrigine exerts its anti-seizure action is not known. The FDA approved lamotrigine in December 1974.
What brand names are available for lamotrigine?
Lamictal, Lamictal CD, Lamictal ODT, Lamictal XR, Lamictal Starter
What are the side effects of lamotrigine?
The most common side effects of lamotrigine are:
Severe, life-threatening rashes have occurred with lamotrigine. The risk of rash is increased if the dose is increased faster than recommended or if patients also are taking valproic acid. Patients taking lamotrigine should report any rash to a physician immediately.
Other important side effects include:
- increased risk of developing aseptic meningitis and
- reduced white blood cells, red blood cells, and platelets.
Multiorgan failure, including fatal liver disease rarely has been observed during lamotrigine treatment.
As a general rule, anti-seizure medications should not be abruptly stopped because of the possibility of increasing the frequency of seizures. In most cases, the dose of lamotrigine should be gradually lowered over a period of at least two weeks. Antiepileptic medications have been associated with an increased risk of suicidal thinking and behavior. Anyone considering the use of antiepileptic drugs must balance this risk of suicide with the clinical need for the drugs. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thoughts, or unusual changes in behavior.
Quick GuideEpilepsy: Symptoms, Causes and Treatment
What is the dosage for lamotrigine?
The dose of immediate release lamotrigine for seizures in patients not taking valproic acid (Depakote, Depakote ER, Depakene, Depacon, Stavzor), but taking seizure medications that reduce lamotrigine blood levels (for example, phenobarbitol, phenytoin [Dilantin, Dilantin-125], carbamazepine [Tegretol], primidone) is 50 mg once daily for two weeks, followed by 100 mg daily given in two divided doses for two weeks. Thereafter, the dose is increased by 100 mg daily every 1-2 weeks up to the usual maintenance dose of 300 to 500 mg daily given as a divided dose.
In patients who are taking valproic acid in which it increases blood levels of lamotrigine, the initial dose of lamotrigine is 25 mg every other day for two weeks, then 25 mg once daily for two weeks. After 4 weeks the dose is slowly increased by 25 to 50 mg per day every one to two weeks until a dose of 100 to 400 mg once daily or divided twice daily is reached. The maintenance dose when using extended release tablets is 200 to 600 mg once daily.
The target dose for treating bipolar disorder is 100 to 400 mg daily.
Which drugs or supplements interact with lamotrigine?
Lamotrigine can interact with valproic acid. When lamotrigine is initiated in patients already receiving valproic acid, the blood concentrations of valproic acid can decrease over a 3-week period. This may result in loss of seizure control. Valproic acid increases lamotrigine levels. The risk of severe skin rash may be increased by combining lamotrigine with valproic acid. There may be a higher incidence of dizziness, double vision, and blurred vision in patients receiving carbamazepine together with lamotrigine. The mechanism of this interaction is unclear.
Estrogen containing oral contraceptives, phenobarbitol, primidone, phenytoin, and rifampin reduce the blood levels of lamotrigine by 40%-50% by increasing the breakdown of lamotrigine in the liver. This may result in reduced efficacy if the dose of lamotrigine is not adjusted.
Is lamotrigine safe to take if I'm pregnant or breastfeeding?
Use of lamotrigine during pregnancy has not been adequately evaluated.
Lamotrigine is secreted into human breast milk. Because the effects on the infant are unknown, breastfeeding while taking lamotrigine is not recommended.
What else should I know about lamotrigine?
What preparations of lamotrigine are available?
- Tablets: 25, 100, 150, and 200 mg.
- Tablets, chewable (CD): 2, 5, and 25 mg.
- Tablets, orally disintegrating (ODT): 25, 50, 100, and 200 mg.
- Tablets, extended release (XR): 25, 50, 100, 200, 250, and300 mg.
How should I keep lamotrigine stored?
Tablets should be stored at room temperature, between 15 C - 30 C (59 F - 86 F).
Lamotrigine (Lamictal, Lamictal CD, Lamictal ODT, Lamictal XR) is a drug used in combination with other anti-seizure drugs for the treatment of partial seizures, tonic-clonic seizures of Lennox-Gastaut syndrome. It is also prescribed for individuals over the age of 18 for the prevention of mood episodes in individuals with bipolar disorder. Side effects, drug interactions, warnings and precautions, and pregnancy safety information should be reviewed prior to taking this medication.
Multimedia: Slideshows, Images & Quizzes
Bipolar Disorder (Mania) Quiz: Test Your Emotional Wellness IQ
Who is at risk for developing bipolar disorder? Are you? Take this Bipolar Disorder Quiz to learn more about bipolar disorder, if...
Picture of Fixed Drug Eruption
A large red-violet plaque on the arm of a child. See a picture of Fixed Drug Eruption and learn more about the health topic....
Related Disease Conditions
Seizures Symptoms and Types
Seizures are divided into two categories: generalized and partial. Generalized seizures are produced by electrical impulses from...
Pain that originates in the face is referred to as trigeminal neuralgia. This pain may be caused by: an injury, an infection...
Epilepsy is a brain disorder in which the person has seizures. There are two kinds of seizures, focal and generalized. There are...
Misophonia is defined as the hatred of sound. Symptoms of this condition include a negative emotional response to certain trigger...
Bipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment...
Posttraumatic Stress Disorder
Post-traumatic stress disorder (PTSD), a psychiatric condition, can develop after any catastrophic life event. Symptoms include...
Fragile X Syndrome
Fragile X syndrome is the most common inherited form of mental retardation. It's caused by a mutation on the X chromosome. People...
Obsessive Compulsive Disorder (OCD)
Obsessive compulsive disorder (OCD) is an anxiety disorder that causes a person to suffer repeated obsessions and compulsions....
Postpartum depression is a form of depression that occurs within a year after delivery. It is thought that rapid hormone changes...
Bipolar Disorder in Children and Teens
Bipolar disorder, or manic-depressive illness, is a disorder that causes unusual and extreme mood changes. Symptoms of bipolar...
Bipolar Disorder vs. Schizophrenia
Bipolar disorder and schizophrenia are mental illnesses that share some risk factors and treatments. Symptoms of bipolar disorder...
Treatment & Diagnosis
- Bipolar Disorder Mania FAQs
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Indications for Drugs: Approved vs. Non-approved
- Drugs: Buying Prescription Drugs Online Safely
- Drugs: The Most Common Medication Errors
- Medication Disposal
- Dangers of Mixing Medications
- Catherine Zeta-Jones: A Case of Bipolar II Disorder
- Generic Drugs, Are They as Good as Brand-Names?
Medications & Supplements
Prevention & Wellness
- Study Sees No Link Between Common Epilepsy Drug, Certain Birth Defects
- Bipolar Disorder Drug May Need Adjusting in Pregnancy, Study Finds
- Epilepsy Drugs in Pregnancy Tied to Developmental Delays in Children
- Migraine Guidelines Focus on Prevention
- Prescription Meds Can Put on Unwanted Pounds
- Study: Low Birth Defect Risk From Newer Epilepsy Drugs
- FDA Warns Lamictal Can Cause Meningitis
- Study: No Proof of Epilepsy Drug Suicide Risk
Daily Health News
Brain & Nervous Resources
Subscribe to MedicineNet's General Health Newsletter
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Top lamotrigine Related Articles
Bipolar DisorderBipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment may incorporate mood-stabilizer medications, antidepressants, and psychotherapy.
Bipolar Disorder in Children and TeensBipolar disorder, or manic-depressive illness, is a disorder that causes unusual and extreme mood changes. Symptoms of bipolar disorder in children and teens include having trouble concentrating, behaving in risky ways, and losing interest in activities they once enjoyed. Treatment for bipolar disorder in children and teenagers incorporates psychotherapy and medications.
Bipolar Disorder QuizWho is at risk for developing bipolar disorder? Are you? Take this Bipolar Disorder Quiz to learn more about bipolar disorder, if you're at risk, and what you can do about it.
Bipolar Disorder vs SchizophreniaBipolar disorder and schizophrenia are mental illnesses that share some risk factors and treatments. Symptoms of bipolar disorder include mood changes and manic and depressive episodes. Symptoms of schizophrenia include unusual behavior, delusions, and hallucinations.
Drug InteractionsDrug interactions occur frequently. Get facts about the types of drug interactions, what substances or other things that may interact with drugs such as OTC drug and prescription drugs, vitamins, food(s) (grapefruit), and laboratory tests. Find out how to protect yourself from potential drug interactions.
Epilepsy TreatmentEpileptic seizures mostly controlled through drug therapy, particularly anticonvulsant drugs. Types of treatment prescribed depends on several factors including the frequency and severity of the seizures as well as the person's age, overall health and medical history. Other forms of treatment options also exist including ketogenic diet and electrical stimulation.
Fixed Drug Eruption PictureA large red-violet plaque on the arm of a child. See a picture of Fixed Drug Eruption and learn more about the health topic.
Fragile X SyndromeFragile X syndrome is the most common inherited form of mental retardation. It's caused by a mutation on the X chromosome. People with Fragile X syndrome suffer from physical, social, emotional, speech, language, sensory, intelligence, and learning impairments. There is no definitive treatment for Fragile X, though there are ways to minimize the symptoms.
MisophoniaMisophonia is defined as the hatred of sound. Symptoms of this condition include a negative emotional response to certain trigger sounds, such as slurping, snoring,yawning, orthroat clearing. Other symptoms include distancing oneself from the trigger, and acting out at the sound's source. Treatment may involve medications, cognitive behavioral therapy, or tinnitus retraining therapy.
Obsessive Compulsive Disorder (OCD)Obsessive compulsive disorder (OCD) is an anxiety disorder that causes a person to suffer repeated obsessions and compulsions. Symptoms include irresistible impulses despite a person's realization that the thoughts are irrational, excessive hand washing, skin picking, lock checking, or repeatedly rearranging items. People with OCD are more likely to develop trichotillomania, muscle or vocal tics, or an eating disorder. Treatment for OCD includes psychotherapy, behavioral therapy, and medication.
Postpartum DepressionPostpartum depression is a form of depression that occurs within a year after delivery. It is thought that rapid hormone changes after childbirth may lead to depression. Symptoms of postpartum depression include crying a lot, headaches, chest pains, eating too little or too much, sleeping too little or too much, withdrawal from friends and family, and feeling irritable, sad, hopeless, worthless, guilty, and overwhelmed. Treatment typically involves talk therapy and medication.
Posttraumatic Stress DisorderPost-traumatic stress disorder (PTSD), a psychiatric condition, can develop after any catastrophic life event. Symptoms include nightmares, flashbacks, sweating, rapid heart rate, detachment, amnesia, sleep problems, irritability, and exaggerated startle response. Treatment may involve psychotherapy, group support, and medication.
SeizureEpilepsy is a brain disorder in which the person has seizures. There are two kinds of seizures, focal and generalized. There are many causes of epilepsy. Treatment of epilepsy (seizures) depends upon the cause and type of seizures experienced.
Seizures Symptoms and TypesSeizures are divided into two categories: generalized and partial. Generalized seizures are produced by electrical impulses from throughout the brain, while partial seizures are produced by electrical impulses in a small part of the brain. Seizure symptoms include unconsciousness, convulsions, and muscle rigidity.
Trigeminal NeuralgiaPain that originates in the face is referred to as trigeminal neuralgia. This pain may be caused by:
- an injury,
- an infection in the face,
- a nerve disorder, or
- it can occur for no known reason.