What to Know About Lamictal (Lamotrigine)

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What is the most important information I should know about Lamictal?You should not take Lamictal if you are hypersensitive to lamotrigine as a serious, life-threatening immune system reaction may occur.Caution should be used if you have a history of liver or kidney problems or if you are taking oral contraceptives, valproate, or certain other anticonvulsants.

What is the most important information I should know about Lamictal?

You should not take Lamictal if you are hypersensitive to lamotrigine as a serious, life-threatening immune system reaction may occur.Caution should be used if you have a history of liver or kidney problems or if you are taking oral contraceptives, valproate, or certain other anticonvulsants.

Lamictal (lamotrigine) is used as amood stabilizerfor people with bipolar disorder and as an anticonvulsant for people with epilepsy.When used to treat bipolar disorder, the drug helps reduce the occurrence of mood episodes. For people with epilepsy, Lamictal prevents seizures, and it may be used alone or together with another anticonvulsant.

Lamictal is taken orally and is available as a tablet intended to be swallowed whole, chewable tablet, or disintegrating tablet that is placed on the tongue. The generic form of Lamictal is called lamotrigine.

Lamictal Uses

For those 18 years and older, Lamictal is used for maintenance treatment of bipolar disorder to reduce the occurrence of mood episodes.

Lamictal is also used to control seizures in people with epilepsy. For children age 2 and older, it’s often prescribed together with another anticonvulsant medication, but it may be used alone for adolescents and adults age 16 and up.

Off-Label UsesAlthough not formally indicated, Lamictal may also be prescribed for other aspects of bipolar disorder and other mood disorders. While Lamictal is indicated as a maintenance drug, some research shows it may also help someone who is experiencing acute bipolar depression. Lamictal may also be prescribed to treat unipolar depression.When a medication is used off-label, it means that the Food and Drug Administration has not approved it for that indication.A 2021 systematic review suggested that research supporting Lamictal’s use for acute bipolar depression is inconsistent, and there was little strong evidence to support its use in the treatment of acute mania, unipolar depression, orrapid-cycling bipolar disorder.

Off-Label Uses

Although not formally indicated, Lamictal may also be prescribed for other aspects of bipolar disorder and other mood disorders. While Lamictal is indicated as a maintenance drug, some research shows it may also help someone who is experiencing acute bipolar depression. Lamictal may also be prescribed to treat unipolar depression.When a medication is used off-label, it means that the Food and Drug Administration has not approved it for that indication.A 2021 systematic review suggested that research supporting Lamictal’s use for acute bipolar depression is inconsistent, and there was little strong evidence to support its use in the treatment of acute mania, unipolar depression, orrapid-cycling bipolar disorder.

Although not formally indicated, Lamictal may also be prescribed for other aspects of bipolar disorder and other mood disorders. While Lamictal is indicated as a maintenance drug, some research shows it may also help someone who is experiencing acute bipolar depression. Lamictal may also be prescribed to treat unipolar depression.When a medication is used off-label, it means that the Food and Drug Administration has not approved it for that indication.

A 2021 systematic review suggested that research supporting Lamictal’s use for acute bipolar depression is inconsistent, and there was little strong evidence to support its use in the treatment of acute mania, unipolar depression, orrapid-cycling bipolar disorder.

Before Taking Lamictal

Before a doctor considers prescribing Lamictal, they will need to evaluate you for bipolar disorder. Your doctor will check to see if you’re experiencingsymptoms of bipolar disorderlike:

If you or a loved one is currently experiencing suicidal thoughts or an impulse to self-harm, contact theNational Suicide Prevention Lifelineat988for help. If you believe the danger is immediate, call 911.

A doctor will also determine whether you fit the criteria forbipolar I or IIand rule out other similar conditions.

Since Lamictal is a maintenance drug, the doctor will likely ensure that you’re not currently experiencing an acute manic or depressive episode before beginning treatment. Your prescribing doctor should also reassess you periodically to make sure you still need maintenance treatment for bipolar disorder.

Precautions and Contraindications

There are some situations where you should not take Lamictal based on your preexisting conditions and other medications you’re currently taking.

If you’ve ever experienced hypersensitivity to lamotrigine in the past, you should not take Lamictal, as this medication carries a risk of a serious, potentially life-threatening rash.

If You Are Pregnant, Trying to Conceive, or Breastfeeding

You should share with the doctor if you’re pregnant or trying to conceive. Data from animal studies show that Lamictal may pose a risk to the fetus, but those results haven’t been observed in people.Caution is warranted, but you should discuss the issue with your doctor. The benefits of Lamictal might outweigh the potential risks in some cases.

Lamictal does appear to travel through breastmilk, so talk to your prescribing doctor before breastfeeding while taking this medication.

If You Have Liver or Kidney Problems

Let the doctor know if you have a history of liver and/or kidney problems. Caution may be warranted in these cases, and your doctor may need to adjust your Lamictal dosage.

If You Are Taking Other Medications

Talk to your doctor about all medications, supplements, and vitamins that you currently take. While some drugs pose minor interaction risks, others may outright contraindicate use or prompt careful consideration as to whether the pros of treatment outweigh the cons in your case.

Certain drugs may cause problems with Lamictal, like:

In some cases, your doctor may need to adjust your dosage; in others, they may recommend another medication instead of Lamictal.

When pregnant or taking hormonal contraceptives and taking Lamictal, your doctor will monitor your lamotrigine serum levels frequently in order to make dosage adjustments as needed to prevent significant fluctuations in your lamotrigine levels.

Other Anticonvulsants

Anticonvulsants, also known as antiepileptic drugs or AEDs, are sometimes used as mood stabilizers for people with bipolar disorder. Other commonanticonvulsants used in bipolar disorder treatmentinclude:

Lamictal Dosage

Lamictal is offered in a tablet form and available in a number of different formulations and strengths:

Lamotrigine is also available as an extended-release formulation called Lamictal XR. It produces more stable serum levels of the medication.

To avoid the risk of a hypersensitivity reaction, Lamictal is usually started at a lower dose and gradually increased over a period of several weeks.The target dose of Lamictal is typically 200mg daily, though this may vary, particularly if you’re taking certain other medications.

Starter kits are available for both Lamictal and Lamictal ODT. These kits provide instructions on how and when to increase dosages, and the instructions vary based on whether you are taking Lamictal alone or with other drugs. The starter kit may be useful if you are starting Lamictal for the first time.

All listed dosages are according to the drug manufacturer. Check your prescription and talk to your prescribing doctor to make sure you are taking the right dose for you.

Modifications

You can disperse Lamictal CD in liquid to make them easier to take. To do this, simply:

Then you should take the entire mixture (don’t take a partial quantity).

How to Take and Store

Lamictal tablets should be swallowed whole. They can be taken with or without water or food, but if you have side effects like nausea, taking your medication with a small snack may help.

Lamictal CD can be swallowed whole, chewed, or diluted in water or fruit juice. If you chew these tablets, you may want to drink a small amount of water or diluted fruit juice to help you swallow.

Lamictal ODT should be placed on your tongue and moved around in your mouth until dissolved. These tablets will dissolve quickly and can be swallowed with or without water. They can also be taken with or without food.

If you miss a dose of this medication, take it as soon as you remember. If it’s almost time for your next dose, however, don’t double up. Simply skip the missed dose and wait for your next dose.

It may take several weeks before you start feeling positive effects from this medication. Be sure to keep taking your recommended dosage; don’t stop because you haven’t noticed any change.

It is possible to overdose on Lamictal. Signs of a Lamictal overdose can include:Abnormalities in an electrocardiogram (ECG)ComaImpaired coordination, slurred speech, stumbling, and fallingLoss of consciousnessUncontrolled, repetitive eye movementsIf you or your loved one suspect an overdose of this medication, call thePoison Control Centerat1-800-222-1222or911immediately for help. Lamictal is rapidly absorbed, so it’s important to act quickly.

It is possible to overdose on Lamictal. Signs of a Lamictal overdose can include:

If you or your loved one suspect an overdose of this medication, call thePoison Control Centerat1-800-222-1222or911immediately for help. Lamictal is rapidly absorbed, so it’s important to act quickly.

Lamictal Side Effects

Common

For people with bipolar disorder, the most common side effects of Lamictal are:

Severe

Lamictal very rarely has been associated with severe, even life-threatening conditions, like:

Lamictal Warnings and Interactions

Lamictal carries a black box warning regarding a potentially life-threatening hypersensitivity drug rash.In some cases, asevere rashcan develop and lead to conditions known as Stevens-Johnson syndrome (SJS) or toxic epidermal necrosis (TEN), both of which require emergency medical treatment.

The risk of developing a serious rash may be increased if:

Children may also face a higher risk of developing a serious rash than adults.

If you notice any type of rash while taking this medication, you should seek immediate medical attention. Severe cases require hospitalization, and once a hypersensitivity reaction has occurred, no matter how mild, Lamictal treatment should never be restarted.

Other potential problems with Lamictal include:

You should remain under the close care of your doctor while taking Lamictal.

You should not stop taking your medication abruptly. If you decide to stop the medication, you may need to wean off slowly aswithdrawal symptomsare possible.

Living With Bipolar Disorder

9 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Food and Drug Administration (FDA).Lamictal (lamotrigine) tablets.Prabhavalkar KS, Poovanpallil NB, Bhatt LK.Management of bipolar depression with lamotrigine: an antiepileptic mood stabilizer.Front Pharmacol. 2015;6:242. doi:10.3389/fphar.2015.00242Reid JG, Gitlin MJ, Altshuler LL.Lamotrigine in psychiatric disorders.J Clin Psychiatry. 2013;74(7):675-684. doi:10.4088/JCP.12r08046National Alliance on Mental Illness.Lamotrigine (Lamictal).Besag FMC, Vasey MJ, Sharma AN, Lam ICH.Efficacy and safety of lamotrigine in the treatment of bipolar disorder across the lifespan: a systematic review.Ther Adv Psychopharmacol. 2021;11:20451253211045870. doi:10.1177/20451253211045870Jarwan RO, Ali M.Delayed presentation of anticonvulsant hypersensitivity syndrome secondary to Lamotrigine.Cureus.2022;14(7):e27399. doi:10.7759/cureus.27399Polepally AR, Remmel RP, Brundage RC, et al.Steady-state pharmacokinetics and bioavailability of immediate-release and extended-release formulations of lamotrigine in elderly epilepsy patients: Use of stable isotope methodology.J Clin Pharmacol. 2015;55(10):1101-1108. doi:10.1002/jcph.522Hashimoto Y, Kotake K, Watanabe N, Fujiwara T, Sakamoto S.Lamotrigine in the maintenance treatment of bipolar disorder.Cochrane Database Syst Rev. 2020;2020(4):CD013575. doi:10.1002/14651858.CD013575Food and Drug Administration (FDA).Lamictal (lamotrigine): drug safety communication - studies show increased risk of heart rhythm problems in patients with heart disease.

9 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Food and Drug Administration (FDA).Lamictal (lamotrigine) tablets.Prabhavalkar KS, Poovanpallil NB, Bhatt LK.Management of bipolar depression with lamotrigine: an antiepileptic mood stabilizer.Front Pharmacol. 2015;6:242. doi:10.3389/fphar.2015.00242Reid JG, Gitlin MJ, Altshuler LL.Lamotrigine in psychiatric disorders.J Clin Psychiatry. 2013;74(7):675-684. doi:10.4088/JCP.12r08046National Alliance on Mental Illness.Lamotrigine (Lamictal).Besag FMC, Vasey MJ, Sharma AN, Lam ICH.Efficacy and safety of lamotrigine in the treatment of bipolar disorder across the lifespan: a systematic review.Ther Adv Psychopharmacol. 2021;11:20451253211045870. doi:10.1177/20451253211045870Jarwan RO, Ali M.Delayed presentation of anticonvulsant hypersensitivity syndrome secondary to Lamotrigine.Cureus.2022;14(7):e27399. doi:10.7759/cureus.27399Polepally AR, Remmel RP, Brundage RC, et al.Steady-state pharmacokinetics and bioavailability of immediate-release and extended-release formulations of lamotrigine in elderly epilepsy patients: Use of stable isotope methodology.J Clin Pharmacol. 2015;55(10):1101-1108. doi:10.1002/jcph.522Hashimoto Y, Kotake K, Watanabe N, Fujiwara T, Sakamoto S.Lamotrigine in the maintenance treatment of bipolar disorder.Cochrane Database Syst Rev. 2020;2020(4):CD013575. doi:10.1002/14651858.CD013575Food and Drug Administration (FDA).Lamictal (lamotrigine): drug safety communication - studies show increased risk of heart rhythm problems in patients with heart disease.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Food and Drug Administration (FDA).Lamictal (lamotrigine) tablets.Prabhavalkar KS, Poovanpallil NB, Bhatt LK.Management of bipolar depression with lamotrigine: an antiepileptic mood stabilizer.Front Pharmacol. 2015;6:242. doi:10.3389/fphar.2015.00242Reid JG, Gitlin MJ, Altshuler LL.Lamotrigine in psychiatric disorders.J Clin Psychiatry. 2013;74(7):675-684. doi:10.4088/JCP.12r08046National Alliance on Mental Illness.Lamotrigine (Lamictal).Besag FMC, Vasey MJ, Sharma AN, Lam ICH.Efficacy and safety of lamotrigine in the treatment of bipolar disorder across the lifespan: a systematic review.Ther Adv Psychopharmacol. 2021;11:20451253211045870. doi:10.1177/20451253211045870Jarwan RO, Ali M.Delayed presentation of anticonvulsant hypersensitivity syndrome secondary to Lamotrigine.Cureus.2022;14(7):e27399. doi:10.7759/cureus.27399Polepally AR, Remmel RP, Brundage RC, et al.Steady-state pharmacokinetics and bioavailability of immediate-release and extended-release formulations of lamotrigine in elderly epilepsy patients: Use of stable isotope methodology.J Clin Pharmacol. 2015;55(10):1101-1108. doi:10.1002/jcph.522Hashimoto Y, Kotake K, Watanabe N, Fujiwara T, Sakamoto S.Lamotrigine in the maintenance treatment of bipolar disorder.Cochrane Database Syst Rev. 2020;2020(4):CD013575. doi:10.1002/14651858.CD013575Food and Drug Administration (FDA).Lamictal (lamotrigine): drug safety communication - studies show increased risk of heart rhythm problems in patients with heart disease.

Food and Drug Administration (FDA).Lamictal (lamotrigine) tablets.

Prabhavalkar KS, Poovanpallil NB, Bhatt LK.Management of bipolar depression with lamotrigine: an antiepileptic mood stabilizer.Front Pharmacol. 2015;6:242. doi:10.3389/fphar.2015.00242

Reid JG, Gitlin MJ, Altshuler LL.Lamotrigine in psychiatric disorders.J Clin Psychiatry. 2013;74(7):675-684. doi:10.4088/JCP.12r08046

National Alliance on Mental Illness.Lamotrigine (Lamictal).

Besag FMC, Vasey MJ, Sharma AN, Lam ICH.Efficacy and safety of lamotrigine in the treatment of bipolar disorder across the lifespan: a systematic review.Ther Adv Psychopharmacol. 2021;11:20451253211045870. doi:10.1177/20451253211045870

Jarwan RO, Ali M.Delayed presentation of anticonvulsant hypersensitivity syndrome secondary to Lamotrigine.Cureus.2022;14(7):e27399. doi:10.7759/cureus.27399

Polepally AR, Remmel RP, Brundage RC, et al.Steady-state pharmacokinetics and bioavailability of immediate-release and extended-release formulations of lamotrigine in elderly epilepsy patients: Use of stable isotope methodology.J Clin Pharmacol. 2015;55(10):1101-1108. doi:10.1002/jcph.522

Hashimoto Y, Kotake K, Watanabe N, Fujiwara T, Sakamoto S.Lamotrigine in the maintenance treatment of bipolar disorder.Cochrane Database Syst Rev. 2020;2020(4):CD013575. doi:10.1002/14651858.CD013575

Food and Drug Administration (FDA).Lamictal (lamotrigine): drug safety communication - studies show increased risk of heart rhythm problems in patients with heart disease.

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