Medication and Treatment Reviews

Lamictal

Generic Name: lamotrigine

Uses

Lamictal, known as lamotrigine in its generic form, is an anticonvulsant medication prescribed in tandem with other medications to prevent and control seizures in children over age two, adolescents, and adults. It treats partial onset seizures, generalized tonic-clonic seizures, and generalized seizures of Lennox-Gastaut syndrome. It is not known if Lamictal is safe or effective when prescribed as an antiepileptic on its own.

Lamictal can also be used to prevent the sudden mood changes that occur as a symptom of bipolar disorder in adults (ages 18-65). The safety and effectiveness of Lamictal is not known for treating bipolar disorder in individuals under age 18 and over age 65.

How to Use Lamictal

Before starting or refilling a Lamictal prescription, read the medication guide included with your pills, as it may be updated with new information.

This guide should not replace a conversation with your doctor, who has a holistic view of your or your child’s medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin taking the medication.

Dosage

As with all medications, follow your Lamictal prescription instructions exactly. You should inspect your prescription, and ensure it is the correct medication and formulation. In the past, some patients have been given the wrong medication because several prescriptions have similar names to Lamictal.

Lamictal is available in several formulations:

  • Lamictal Tablet: Swallowed whole with water or another liquid. Tablets are available in 25mg, 100mg, 150mg, and 200mg doses.
  • Lamictal Chewable Dispersible Tablets: Swallowed whole, chewed, or mixed with 1 teaspoon of water or a diluted fruit juice. If chewed, follow with a sip of water or another liquid to help with swallowing all medication. Tablets are available in 2mg, 5mg, and 25mg doses.
  • Lamictal XR (Extended-Release): Taken once daily in the morning with water or another liquid. Tablets are available in 25mg, 50mg, 100mg, 200mg, 250mg, and 300mg doses. It is not known if Lamictal XR is safe for children under age 13.
  • Lamictal ODT (Orally Disintegrating Tablet): Taken with or without water or another liquid, with or without food. Tablets are available in 25mg, 50mg, 100mg, and 200mg doses. To keep it from dissolving before you place the tablet in your mouth, leave it contained in its blister package until you are ready to take it. When opening the medication, make sure your hands are clean and dry so as not to accidentally trigger dissolution. Peel back the blister package backing to take out the tablet, instead of pushing it through the foil. Place the tablet on your tongue where it will dissolve. Do not crush or chew the tablet.

The optimal dosage varies by patient; it is impacted by other medications the patient is taking, condition treated, and patient age. To minimize the risk side effects, your doctor may start you on a low dose, and gradually increase to the desired dosage over five weeks.

It may take several weeks or months of treatment for Lamictal to reach full effectiveness. If you miss a dose of Lamictal, take it as soon as you remember, unless it is almost time for your next dose. You should not take two doses of Lamictal simultaneously.

When discontinuing treatment, or decreasing dosage, patients should work with a doctor to gradually taper the level of medication over a minimum of two weeks’ time. Stopping Lamictal suddenly can cause serious health problems including seizures that do not stop.

Side Effects

The most common side effects of Lamictal are as follows: dizziness, headache, blurred or double vision, decreased motor coordination, sleepiness, nausea, vomiting, difficulty sleeping, tremor, rash, fever, abdominal pain, and dry mouth. If you stop taking Lamictal suddenly, a seizure that does not stop can occur. Do not stop taking, or change the dosage of a Lamictal prescription without contacting your healthcare provider.

Tell your doctor if you have had an allergic reaction to a medication similar to Lamictal, or have a history of liver or kidney problems. Lamictal can sometimes cause severe allergic reaction, organ failure, or problems with blood cells. The warning signs of a serious reaction include: a skin rash, hives, fever, swollen lymph glands, painful sores in the mouth or around the eyes, swelling of your lips or tongue, yellowing of your skin or eyes, unusual bruising or bleeding, severe fatigue, severe muscle pain, or frequent infections. Seek medical help immediately if you experience these symptoms.

Taking Lamictal may impair your ability to drive, operate machinery, or perform other potentially dangerous tasks. This side effect usually wears off with time. If side effects are bothersome, or do not go away, talk to your doctor.

Most people taking this medication do not experience any of these side effects.

Tell your doctor if you are taking valproate. Lamictal can cause a severe, sometimes life-threatening skin rash – including Stevens-Johnson syndrome and toxic epidermal necrolysis – for certain patients, and the risk is higher while using this medication. The rash can result in hospitalization, and rarely death. Contact your doctor immediately at the first sign of a rash.

Disclose to your physician all mental health issues including any family history of suicide, anxiety, mania, or depression. Lamictal may create new or exacerbate existing suicidal thoughts or mental problems. Call your doctor immediately if you or your child experiences new or worsening mental health symptoms including panic attacks or unusual changes in mood.

In rare cases, Lamictal can cause aseptic meningitis, a severe and potentially life threatening inflammation of the membrane around the brain and spinal cord. Contact your doctor immediately if you experience stiff neck, unusual sensitivity to light, headache, or any other symptoms of meningitis.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

Precautions and Safety

Store Lamictal in a secure place out of reach of children, and at room temperature. If you are taking the quick-dissolving tablet, keep the tablets in the blister packaging and hard plastic travel case or carton until you are ready to take it.

You should not take Lamictal if you have had an allergic reaction to lamotrigine or any ingredients in Lamictal. Tell your doctor if you have ever had a rash or allergic reaction to another antiseizure medication.

If you are thinking of becoming pregnant, discuss the use of Lamictal with your doctor. Animal studies show a potential risk of fetal or maternal harm. If you become pregnant while taking Lamictal, do not stop taking it immediately without discussing it with your physician. Consider registering with the North American Antiepileptic Drug Pregnancy Registry.  They are actively collecting information about the safety of anticonvulsants during pregnancy. Lamictal is passed through breastmilk, so it is recommended that mothers do not nurse while taking it.

Interactions

Before taking Lamictal, discuss all other active prescription medications with your doctor.

Lamictal can have a drug interaction with oral contraceptives, and other hormonal medications. It can cause side effects including changes in menstrual pattern, dizziness, lack of coordination, double vision, or decreased effectiveness of both medications. The following medications also decrease the effectiveness of Lamictal when taken together:

  • Carbamazepine
  • Phenobarbital/Primidone
  • Phenytoin
  • Rifampin

Taking valproate concurrently with Lamictal can increase the concentration in the body, which increases the likelihood of developing a severe skin rash reaction.

Share a list of all vitamin or herbal supplements, and prescription and non-prescription medications you take with the pharmacist when you fill your prescription, especially any drugs that cause drowsiness. Let all doctors and physicians know you are taking Lamictal before having any surgery or laboratory tests. The above is not a complete list of all possible drug interactions

Sources:

http://www.fda.gov/downloads/drugs/drugsafety/ucm166013.pdf
http://www.fda.gov/downloads/drugs/drugsafety/ucm152835.pdf
http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/PediatricAdvisoryCommittee/UCM235547.pdf

4 reviews

  1. My son takes Lamictal for his complex partial seizures but I think it is helping him in more ways than just that. He also takes Focalin, Daytrana and Intuniv. So I feel it was a good addition. We just started the extended release a week ago and it sure helps not taking so many small ones like we started out and slowly increased the dose.

  2. I had tried for 7 years to find a medicine combination that would -give me even close to a sense of productive. Lamictal and Effexor XR made a big difference, in everyday life able to get kids off to school on time with lunch boxes! Last month I introduced 50mg of Lyrica at night and wow! Now I have access to my brain again. I sleep through the night and do not get overwhelmed when trying to focus on a task.

  3. I used Lamictal to treat my bipolar mania in 2012, and it was a DISASTER for me. I developed Stevens-Johnson Syndrome while on vacation, so not only did I have to stop cold turkey, but I also had to deal with itching, sores, and mood swings until I got home. Once I saw my doctor, I had to take steroids to clear up the sores, which is not fun when you’re prone to manic episodes.

  4. I take Aplenzin for depression and I take Lamictal for a mood-stabilizing effect similar to what people get from Abilify. I took Abilify and I felt really good for a few days then started feeling unreal and just really strange. It scared me so I stopped it. The Lamictal really, really helps me.

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