My Experience with Lamictal (Psychiatric Medication)
What Is Lamictal (Lamotrigine)?
Lamictal is the brand name of lamotrigine, an anti-epileptic medication that belongs to a class of drugs known as anticonvulsants.
Lamictal is used alone or in combination with other drugs to treat seizures in adults and children with epilepsy.
It's also used to treat Lennox-Gastaut syndrome, an extreme form of epilepsy that causes seizures and often causes developmental delays in children.
In addition, Lamictal is commonly prescribed to adults with bipolar disorder (manic depression) to delay episodes of depression and mania. (Mania is defined as frenzied or abnormally excited moods).
Lamictal is also prescribed off-label to treat clinical depression and migraine headaches.
The FDA first approved Lamictal in 1994 as an anti-seizure medication. Approval to use the drug in the treatment of bipolar disorder was given in 2003.
Lamictal is manufactured by GlaxoSmithKline.
Your age impacts the type and dose of Lamictal you can take. The immediate-release form of Lamictal is given to children as young as age 2, but only in addition to other seizure medications.
It's not given as a stand-alone medication in someone who is younger than 16.
The extended-release form, Lamictal XR, is only prescribed to patients 13 years old and older.
The Food and Drug Administration (FDA) requires Lamictal to carry a black-box warning because this medication can cause serious rashes requiring hospitalization.
This is more likely in children and people taking very high doses from the start or increasing the dose too fast, and taking it with a medication called valproate (Depakote).
Very rare cases of toxic epidermal necrolysis, or rash-related death, have been reported worldwide.
Nearly all cases of life-threatening rashes have occurred during the first two to eight weeks of treatment, although it's possible this complication could show up after taking the medicine for a long time.
This drug can also cause a rash that's not serious. Since it's difficult to tell the difference in early stages, it's important to contact your doctor at the first sign of any rash.
Five to 10 percent of people taking Lamictal will develop a rash, but less than 1 percent of people will develop a serious rash.
Studies concluded by the FDA in 2008 also showed a small number of patients taking Lamictal developed symptoms of suicidal behavior, including suicidal thoughts or actions.
The FDA requires this medication also carry a warning letting patients know those risks.
In 2010, the FDA issued a safety announcement letting doctors know Lamictal can cause aseptic meningitis.
Meningitis is an inflammation of the protective membranes (the meninges) that cover the brain and spinal cord. In most cases, symptoms disappeared when patients stopped taking Lamictal.
This drug should not be stopped suddenly. Stopping an anti-seizure medication can cause you to have an increase in seizures. Talk to your doctor before making a decision to stop or change your medication.
Tell your doctor if you have a history of kidney or liver disease, or if you are allergic to other seizure medications.
This medication may cause you to have thoughts of suicide. Tell your doctor if you have a history of depression or mental illness.
Once you are on the medication, keep your appointments and let your doctor know if you develop any mood changes, including suicidal thoughts or a depression that is getting worse.
Pregnancy and Lamictal
Lamictal is an FDA Pregnancy Category C drug, meaning it's not known if it will harm an unborn baby.
Tell your doctor if you are pregnant or planning a pregnancy. Taking this medication while pregnant (especially in early pregnancy) can increase the risk of a baby being born with a cleft lip or palate.
This drug can also pass into breast milk so discuss the risks before breastfeeding an infant.
Taking birth control pills can make this medication less effective, resulting in an increase of symptoms like seizures.
Tell your doctor if you plan to stop or start birth control pills so he or she can adjust your dose.
Lamictal Side Effects
Common Side Effects of Lamictal (Lamotrigine):
Let your doctor know if any of these side effects persist or get worse.
- Changes in menstrual periods
- Back pain
- Insomnia (trouble sleeping)
- Blurred or double vision
- Shaking (tremors)
- Upset stomach
- Feeling tired
- Runny nose
- Sore throat
Serious Side Effects of Lamictal (Lamotrigine):
Tell your doctor immediately if you develop any serious side effects of Lamictal.
- Any rash, even if it doesn't seem serious to you
- A worsening depression or suicidal thoughts
- Flu-like symptoms (swollen glands, body aches, headache, neck stiffness or pain, and increased sensitivity to light)
- Signs of infection like fever, stiff neck or a persistent sore throat
- Easy bruising or bleeding
- Stomach pain
- Loss of appetite
- Dark urine
- Jaundice (yellowing of skin or eyes)
- Pale skin
- Chest pain
- Rapid heartbeat
- Irregular breathing
- Shortness of breath
- Loss of coordination
- Severe nausea and vomiting
- Urinating less or not at all
- Increased seizures
- Increased symptoms of bipolar disorder
- Muscle weakness, pain, or tingling
Seek immediate emergency attention if you develop any of the following:
- Swelling, especially in the face, tongue, lips, or throat
- Painful sores in or around your mouth
- Trouble breathing
- Swollen glands
- Extreme fatigue
This medication could have a very serious interaction with valproic acid (Depakene). Taking these two drugs together could cause the levels of Lamictal in your blood to increase and result in a life-threatening rash.
Taking this drug with lopinavir ritonavir (Kaletra) or rifampin (Rifadin) could decrease the amount of Lamictal in your blood and make it less effective. This could result in your symptoms coming back.
Hormonal birth control (such as the pill, patch, or ring) can also decrease the effectiveness of Lamictal.
Taking Lamictal and other anticonvulsants (such as carbamazepine, phenytoin, phenobarbital, and primidone) could increase how quickly your liver processes Lamictal. This could decrease the amount of Lamictal in your system to levels that make the drug ineffective.
Check with your doctor before taking any drugs that cause drowsiness, including antihistamines, drugs for sleep or anxiety (like alprazolam, diazepam, zolpidem), muscle relaxants, narcotic pain relievers (like codeine), or over-the-counter medications for allergies, cough, or cold.
This medication can make you dizzy. Drinking alcohol could increase the effect.
You should always tell your healthcare professional about all prescription, non-prescription, over-the-counter, illegal and recreational drugs, herbal remedies, nutritional and dietary supplements, and any other drugs and treatments.
This medication comes in three forms: a tablet (to swallow), a chewable tablet, and an orally disintegrating tablet.
Do not crush, chew, or break a Lamictal tablet. Swallow it whole.
To take the chewable tablet, chew it or swallow it whole with water. You can also put the tablet in a teaspoon of water or diluted juice and allow it to dissolve for about a minute. Swirl it around gently then take it right away. Once the tablet is dissolved in liquid you cannot save it to use later.
Do not swallow the orally disintegrating tablet (ODT) whole. Place it on your tongue and let it dissolve. You can drink a little liquid to help things along.
Your dose will depend on what your doctor decides is right for you. Always take this drug exactly as your doctor prescribes. Your doctor may change your dose occasionally until you find the right balance. A blood test may be required to make sure you're taking the right amount.
Taking too much Lamictal at the start of treatment may increase your risk of a severe life-threatening skin rash so follow your dosing instructions carefully.
Extended-release Lamictal XR may be used to treat different conditions than immediate-release Lamictal. Always check your refills to make sure you've received the right medication.
Do not stop taking Lamictal without talking to your doctor, even if you feel well. Stopping suddenly can have serious side effects including an increase in seizures.
Store at room temperature away from moisture.
Seek emergency medical attention or call the poison help line at (800) 222-1222.
Overdose symptoms may include:
- Blurred vision
- Increased seizures
- Feeling light headed
- Loss of coordination
Missed Dose of Lamictal
Take the missed dose as soon as you remember. Skip the missed dose if it's almost time for your next scheduled dose. Do not "double up."
Q: Does Lamictal cause weight gain?
Q: What medications should be avoided when taking Focalin and Lamictal?
A: According to the package insert for Focalin (dexmethylphenidate hydrochloride), Focalin should not be taken during treatment with monoamine oxidase inhibitors, and also within a minimum of 14 days following discontinuation of a monoamine oxidase inhibitor (hypertensive crises may result). Other drug interactions are listed in Focalin's package insert, but no other drugs are recommended to be avoided with Focalin. Although Lamictal (lamotrigine) can interact with other medications, according to the package insert, Lamictal doesn't list any medications that should not be taken with Lamictal. It is important for patients to consult their physician or healthcare provider about any patient specific questions regarding medical conditions or medications; particularly before taking any action. To learn more about Focalin: //www.everydayhealth.com/drugs/focalin To learn more about Lamictal: //www.everydayhealth.com/drugs/lamictal Derek Dore, PharmD
Q: My psychiatrist took me off Lamictal and put me on Celexa. I just got my shipment by mail and Lamictal was there and Celexa was not. Should I take them both at the same time?
A: Your question is an urgent matter. You should consult your physician about when to stop or start these medicines. Lamictal (lamotrigine) and Celexa (citalopram) should not be stopped abruptly; a taper-down schedule is recommended. Burton Dunaway, PharmD
Q: I take Lamictal and temazepam. Do they lower libido, acting either separately or together?
A: There have been several reports of Lamictal decreasing the patient's libido. In some cases, the physician has had to find the lowest possible effective dose that will work, in order to solve the problem. Given that the point of the medication is to control seizures, this can be very difficult to do. If this is a side effect that is significantly affecting your quality of life, you should discuss it with your doctor. Matt Curley, PharmD
Q: Will the generic form of Lamictal (lamotrigine) work as well for depression?
Q: I have been on Lamictal for the past three years, is it possible to become tolerant?
A: Lamictal (lamotrigine) is an anticonvulsant medication that is used to treat seizures in epileptic patients, and mood swings in patients with bipolar disorder. Periodically, your physician may need to adjust the dose of Lamictal in order to maintain effectiveness. Do not stop taking Lamictal without consulting your physician. Some patients may have increased seizures if Lamictal is stopped abruptly. Consult your physician if your symptoms return or are not resolved while taking Lamictal, it is possible that the dosage needs adjustment. When your doctor prescribes a new medication, be sure to discuss all your prescription and over-the-counter drugs, including dietary supplements, vitamins, as well as the foods you eat. Always keep a current list of the drugs and supplements you take and review it with your healthcare providers and your pharmacist. If possible, use one pharmacy for all your prescription medications and over-the-counter products. This allows your pharmacist to keep a complete record of all your prescription drugs and to advise you about drug interactions and side effects. Burton Dunaway, PharmD.
Q: Can Lamotrigine cause stomach problems? If so, what are they?
A: Lamictal (lamotrigine) is a medication that is used to treat epilepsy and bipolar disorder. It is used in combination with other medications to treat seizures in adults and children and it is used to delay mood episodes in patients with bipolar disorder. The prescribing information on lamotrigine lists the following as common side effects of this medication: dizziness, double vision, drowsiness, headaches, coordination problems, nausea or vomiting. Some less common side effects related to stomach problems are: indigestion/heartburn, abdominal pain, and constipation. For more information on lamotrigine, click on this link: //www.everydayhealth.com/drugs/lamictal If you are experiencing side effects from this medication that are bothersome or don't feel quite right, you should consult with your physician. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Lori Poulin, PharmD
Q: I have been taking Lamictal for seizures for quite a few years. What kind of side effects could it have on me?
A: Lamictal (lamotrigine) is an anticonvulsant or anti-seizure medication. It is used either alone or in combination with other medications to treat seizures, delay mood episodes in people with bipolar disorder, and to treat certain types of pain. Common side effects of Lamictal include dizziness, drowsiness, blurred vision, nausea, vomiting, stomach upset, diarrhea, headache, lack of coordination, weight loss, insomnia, and unusual dreams. Other more serious side effects can occur, but are rare or less frequent. These include liver problems, a severe skin reaction, anemia, and severe mood disorders. Contact your doctor right away or seek immediate medical attention for any of these more serious side effects. Symptoms of liver problems can include nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stool, and jaundice (yellowing of the skin and eyes). A serious skin reaction would involve a severe rash with blistering, peeling, and flu-like symptoms. Severe mood disorders are more common in the first 24 months of treatment and include new or worsening mood or behavior changes, depression, anxiety, agitation, hostility, restlessness, hyperactivity, or thoughts of suicide or hurting yourself. This is not a complete list of side effects that can occur with Lamictal. Sarah Lewis, PharmD
Q: Is Lamictal good for depression or bipolar disorder? Does it make you gain weight?
A: Lamictal (lamotrigine) is in a class of medications known as anti-epileptics or anti-seizure. Lamictal is also approved for treating mood episodes in adults with bipolar disorder. Weight loss is actually more likely than weight gain in patients taking Lamictal. The most common side effects of Lamictal are blurred or double vision; constipation; decreased coordination; diarrhea; dizziness; drowsiness; headache; nausea; painful menstrual periods; runny or stuffy nose; stomach upset or pain; tiredness; trouble sleeping; vomiting; weakness; and weight loss. Although rare, Lamictal can cause serious health problems such as organ failure, life threatening skin reactions, and blood disorders. Lamictal can interact with other medications. When your doctor prescribes a new medication, be sure to discuss all your prescription and over-the-counter drugs, including dietary supplements, vitamins, as well as the foods you eat. Always keep a current list of the drugs and supplements you take and review it with your health care providers and your pharmacist. If possible, use one pharmacy for all your prescription medications and over-the-counter products. This allows your pharmacist to keep a complete record of all your prescription drugs and to advise you about drug interactions and side effects. Burton Dunaway, PharmD.
Q: What foods interact with Lamictal?
A: Lamictal (lamotrigine) is used for the long-term treatment of bipolar I disorder to lengthen the time between mood episodes in people 18 years or older who have been treated for mood episodes with other medicine. Lamictal is also used, together with other medicines, to treat certain types of seizures (partial seizures, primary generalized tonic-clonic seizures, generalized seizures of Lennox-Gastaut syndrome) in people 2 years or older, or alone when changing from other medicines used to treat partial seizures in people = 16 years. Food consumption does not appear to affect the bioavailability and/or metabolism of Lamictal. When your doctor prescribes a new medication, be sure to discuss all your prescription and over-the-counter drugs, including dietary supplements, vitamins, botanicals, minerals, and herbals, as well as the foods you eat. Always keep a current list of the drugs and supplements you take and review it with your health care providers and your pharmacist. If possible, use one pharmacy for all your prescription medications and over-the-counter products. This allows your pharmacist to keep a complete record of all your prescription drugs and to advise you about drug interactions and side effects. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. , Shereen A. Gharbia, PharmD
Q: Can Lamictal cause strange dreams to occur and waking up in the middle of the night?
A: Lamictal (lamotrigine) is an anti-seizure medicine that is used to treat bipolar disorder. According to the package insert, the most common side effects of Lamictal are headache, rash and itching, dizziness, diarrhea, and abnormal dreams. This is not a complete list of the side effects associated with Lamictal. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Some other possible causes of nightmares include having a late-night snack, which can increase metabolism and brain activity; withdrawal from medications and substances such as alcohol; sleep deprivation or sleep disorders; and psychological disorders such as anxiety and depression. If you think a drug you are taking is causing bad dreams, tell your health care provider. Do not stop any medication or change the dose without first talking to your provider. Tell your health care provider about any negative side effects from prescription drugs. You can also report them to the U.S. Food and Drug Administration by visiting https://www.fda.gov/Safety/MedWatch/default.htm or by calling 1-800-FDA-1088. Michelle McDermott, RPh, PharmD
Q: Is there a cheaper alternative to Lamictal? I had to stop taking and since stopping it, I'm having problems again.
A: Lamictal (generic name lamotrigine) is used to control seizures and also for a mood stabilizer for bipolar disorder. The generic for Lamictal or lamotrigine is available in the United States. Check with local pharmacies for prices on the generic drug. There are also patient assistance programs by some pharmaceutical companies for individuals that cannot afford their medication. Glaxo-Smith-Kline markets the drug Lamictal and information for their assistant program is: Lamictal Glaxo Wellcome Inc. Glaxo Wellcome Patient Assistance Program P.O. Box 52185 Phoenix, AZ 85072-9711 800/722-9294 Fax: 800/750-9832 A physician may also be able to recommend a cheaper alternative drug for the medical condition. For more information on Lamictal visit Everyday Health at //www.everydayhealth.com/drugs/. Kimberly Hotz, PharmD
Q: Can Lamictal cause headaches either when titrating the dose up or down?
A: Lamictal (lamotrigine) is a medication that is used to treat various conditions including seizures and bipolar disorder. It is not exactly known how this medication works to help alleviate the symptoms of these conditions. The prescribing information on Lamictal does list headaches as a side effect of this medication, occurring in up to 29 percent of patients taking the medication during clinical studies. Other common side effects are: dizziness, double vision, coordination problems, blurred vision, nausea, and vomiting. Lamictal can also cause a very serious rash or other allergic type of reaction. Contact your health care provider if you experience: hives, fever, swollen glands, sores around the mouth or eyes, swelling of the lips/tongue, yellowing of the skin or eyes, frequent infections, severe muscle pain, severe weakness or fatigue, or frequent infections. It is possible to see an increase or decrease in these side effects when changing the dosage of Lamictal. Take Lamictal exactly as prescribed. Do not stop taking Lamictal on your own. Stopping Lamictal suddenly can be dangerous. If any side effects become bothersome or affect your daily activities you should consult with your physician. Lori Poulin, PharmD
Q: Can Lamictal make your urine dark? If so, does it mean it is affecting your liver in a bad way?
A: Lamictal (lamotrigine) is a medication that is used to treat various conditions, including epilepsy and bipolar disorder. It is not known exactly how this medication works to relieve the symptoms of those conditions, but it is thought to have some activity affecting the chemicals in the brain. According to the prescribing information for Lamictal, the most common side effects of this medication include dizziness, double vision, headaches, nausea, drowsiness, stomach pain, insomnia, heartburn, and diarrhea. If you experience anything unusual or bothersome while taking Lamictal, report them to your physician. Liver problems can occur, very rarely, with this medication and if you are experiencing dark-colored or cola colored urine you should report this to your physician immediately, especially if you are noticing a yellowing of the skin or eye color, have fever, nausea/vomiting, or feel more tired than usual. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Lori Poulin, PharmD
Q: My granddaughter keeps having bouts of severe spasmodic bilateral abdominal pain. It's not her ovaries or appendix. She has no diarrhea or fever. Could it be Lamictal?
A: Lamictal (lamotrigine) is a medication used to treat epilepsy and bipolar disorder. In a study of 339 patients, ranging in age from two to 16 years of age, 10 percent of patients taking the immediate-release medication for epilepsy experienced abdominal pain versus five percent taking a placebo. This is not a common reaction, but it is possible. Other common side effects reported with treatment with Lamictal include dizziness, drowsiness, mild nausea, vomiting, diarrhea, upset stomach, headache, lack of coordination, weight loss, insomnia, unusual dreams, runny or stuffy nose, or blurred vision. Serious side effects may also occur and require immediate medical attention. These reactions may include fever, sore throat, headache with severe blistering, peeling, and red skin rash, chest pain, pale skin, easy bruising or bleeding, body aches, flu symptoms, muscle pain, tenderness, or weakness, dark colored urine, clay-colored stools, stomach pain, or jaundice (yellow of the skin or eyes). Consult with doctor for proper evaluation of the abdominal pain and to determine the underlying cause and possible treatment options, if necessary. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action.
Video: LAMOTRIGINE (LAMICTAL) - DRUG TALK - EPISODE 9
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