- What Is It?
- Side Effects
- Drug Interaction
- Preparation & Storage
What is lamotrigine, and how does it work (mechanism of action)?
Lamotrigine is an oral pill 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
Is lamotrigine available as a generic drug?
Do I need a prescription for lamotrigine?
What are the side effects of lamotrigine?
Severe, life-threatening rashes have occurred with lamotrigine. The risk of a 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, as there's no way to tell at the onset whether the rash will be mild or severe.
Common side effects
The most common side effects of lamotrigine are:
Other important side effects include:
- increased risk of developing aseptic meningitis and kidney stones
- reduced white blood cells, red blood cells, and platelets
- loss of appetite and weight loss
- suicidal thoughts or behaviors
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 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.
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, phenobarbital, 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 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 pills is 200 to 600 mg once daily.
The target dose for treating bipolar disorder is 100 to 400 mg daily.
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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 3 weeks. 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, phenobarbital, 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?
The use of lamotrigine during pregnancy has not been adequately evaluated.
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).
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Lamotrigine (Lamictal) 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.
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Pain 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. Trigeminal neuralgia can be treated with antiseizure medications. Some antidepressant drugs also have significant pain relieving effects.
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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.
Seizures Symptoms and Types
Seizures 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.
Epilepsy 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.
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Post-traumatic Stress Disorder
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Fragile X Syndrome
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Bipolar 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.
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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 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.
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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.