Lamictal (A complete guide)

Lamictal

Lamictal, generic name lamotrigine, is a medication used to treat seizures and bipolar disorder. 

What is Lamictal (lamotrigine)?

Lamotrigine is used alone or with other medications to prevent and control seizures. It may also be used to help prevent the extreme mood swings of bipolar disorder in adults.

How does Lamictal (lamotrigine) work?

Lamotrigine is known as an anticonvulsant or antiepileptic drug. It is thought to work by restoring the balance of certain natural substances in the brain.

Lamotrigine is used alone or together with other medicines to help control certain types of seizures (eg, partial seizures, tonic-clonic seizures, or Lennox-Gastaut syndrome) in the treatment of epilepsy. This medicine cannot cure epilepsy and will only work to control seizures for as long as you continue to take it.

Lamictal (A complete guide)

Bipolar disorder causes extreme moods either up or down

What are some key facts about Lamictal (lamotrigine)?

·       it’s usual to take lamotrigine once or twice a day, with or without food

·       the most common side effects of lamotrigine are skin rashes and headaches

·       it can take up to six weeks for lamotrigine to work and you may still have fits (seizures) or feel low during this time

·       the most common brand name is Lamictal

·       Lamotrigine can be taken by adults, and by children aged two years and over

·       Lamotrigine is not suitable for some people.

What is the dosage of Lamictal (lamotrigine)?

For epilepsy, the usual dose for adults and older children (aged 12 years and over) is 100mg to 700mg a day, taken as one or two doses. For younger children (aged two to 11 years) – the dose will vary depending on their weight.

For bipolar disorder, the usual dose for adults is between 200mg and 400mg a day, taken as either one or two doses.

How is Lamictal (lamotrigine) taken?

You can take lamotrigine chewable or dispersible tablets several ways, depending on what you prefer.You can swallow them whole with water, chew them, or mix them with water or juice to make a drink. You can take lamotrigine with or without food.

If you take lamotrigine twice a day, try to space your doses evenly through the day. For example, first thing in the morning and in the evening.

When you start taking lamotrigine, it’s important to increase the dose slowly as this will help reduce or prevent some side effects happening. Once you find a dose that suits you, it’ll usually stay the same.

Lamictal (A complete guide)

When you start taking lamotrigine, it’s important to increase the dose slowly.

What are common side effects of Lamictal (lamotrigine)?

These common side effects may happen in more than 1 in 100 people. They’re usually mild and go away by themselves. Remember that a doctor will prescribe this medication because he or she has judged that the benefit is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Talk to your doctor if these side effects bother you or do not go away:

·       headaches

·       feeling drowsy, sleepy or dizzy

·       aggression, or feeling irritable or agitated

·       shaking or tremors

·       difficulty sleeping

·       diarrhoea

·       feeling or being sick (nausea or vomiting).

More serious side effects are rare, but can include:

·       thoughts of harming or killing yourself – a small number of people taking lamotrigine for bipolar disorder have had suicidal thoughts, and this can happen after only a few weeks of treatment

·       worsening seizures (if you take lamotrigine for epilepsy)

·       unexpected bruising or bleeding, a high temperature or sore throat – these could be warning signs of a blood disorder

·       a stiff neck, headaches, feeling or being sick, a high temperature and extreme sensitivity to bright light – these could be signs of meningitis.

In very rare cases it’s possible to have a serious allergic reaction (anaphylaxis) to lamotrigine.

Who should take Lamictal (lamotrigine)? 

This drug is prescribed for both epilepsy seizures and bipolar disorder.

Seizures are the result of abnormal electrical activity in the brain. They may go nearly unnoticed. Or, in some severe cases, may cause unconsciousness and uncontrollable convulsions.

Seizures usually come on suddenly. How long and severe they are can vary. A seizure can happen just once, or over and over. If they keep returning, that’s epilepsy, or a seizure disorder. Less than one in 10 people who have a seizure get epilepsy.

There are two general categories of seizures:

1.    Generalized Seizures involve your entire brain from the start. Common subtypes include:

·      Tonic-clonic (grand mal): This is the most common subtype. The arms and legs get stiff, and breathing may stop for a bit. Then the limbs will jerk around. The head will also move about.

·      Absence seizures (petit mal): Awareness is briefly lost when you have one of these. Children get them more often than adults. Typically, they last only a few seconds.

·      Febrile seizures: A child can have convulsions from a high fever caused by an infection. They can last a few minutes but are usually harmless.

·      Infantile spasms: These usually stop by age four. The child’s body suddenly goes stiff and the head goes forward. Many children who have these get epilepsy later in life.

2.    Partial (Focal) Seizures

This type begins in a specific area of the brain. They may spread to the entire brain. There are two types:

·      If you have a focal onset aware seizure, you remain conscious. The seizure is very brief (usually less than two minutes). You may or may not be able to respond to people while it’s happening.

·      Focal onset impaired awareness seizures can cause unconsciousness. You may also do things without knowing it, like lip smacking, chewing, moving your legs or thrusting your pelvis.

What Causes Seizures?

Often, it’s unknown. Many things can bring them on, including:

  • stroke
  • cancer
  • brain tumors
  • head injuries
  • electrolyte imbalance
  • very low blood sugar
  • repetitive sounds or flashing lights, as in video games
  • some medications, like antipsychotics and some asthma drugs
  • withdrawal from some medications, like Xanax, narcotics, or alcohol
  • use of narcotics, such as cocaine and heroin
  • brain infections, like meningitis.
Lamictal (A complete guide)

Bipolar disorder – people who are diagnosed with bipolar disorder may be prescribed Lamictal. Bipolar disorder is a brain disorder that causes extreme shifts in mood, energy, and activity levels, and severely interferes with everyday life. 

Symptoms of bipolar disorder include both manic and depressive episodes. Signs of a manic episode are: 

·      feeling very “up” or elated

·      increased energy and activity levels

·      feeling jumpy or wired 

·      trouble sleeping (insomnia)

·      talking very fast about a lot of different things

·      agitation or irritability

·      thoughts racing 

·      think they can do a lot of things at once 

·      taking risks such as spending a lot of money or having reckless sex.

Lamictal (A complete guide)

Depressive episodes can cause feelings of sadness, emptiness or hopelessness.

The following are symptoms of a depressive episode: 

·      feelings of sadness, emptiness or hopelessness 

·      very low energy and activity levels 

·      trouble sleeping (either sleeping too much or too little) 

·      loss of enjoyment in hobbies or activities

·      feelings of worry 

·      trouble concentrating and trouble remembering things 

·      changes in appetite (either eating too much or too little)

·      feeling sluggish 

·      thoughts of death or suicide.

If you or someone you know is having thoughts of suicide, seek help immediately. 

There are two main types of bipolar disorder: Bipolar I Disorder and Bipolar II Disorder. 

Bipolar I Disorder is defined by manic episodes that last at least seven days, or severe manic symptoms that require immediate hospitalization. Depressive episodes occur as well and usually last at least two weeks. Bipolar I Disorder patients may also have mixed episodes with both manic and depressive symptoms simultaneously. 

Bipolar II Disorder is characterized by a pattern of depressive episodes and hypomanic episodes. Hypomanic episodes have some features of typical manic episodes, but are not severe enough to be considered manic. 

Frequently asked questions (FAQs) about Lamictal (lamotrigine):

1.    Is Lamictal a good mood stabilizer?

Lamictal is effective in preventing depressive episodes in patients diagnosed with bipolar disorder. It was the first US FDA-approved drug since lithium for bipolar disorder. Lamictal is considered a mood-stabilizer and an anticonvulsant and is commonly prescribed to patients with bipolar disorder and in patients with epilepsy. 

2.    Is Lamictal used for anxiety?

Lamictal is not typically prescribed for the treatment of anxiety alone. It does, however, decrease abnormal activity in the brain so it is extremely effective for the treatment of depressive effects of bipolar disorder as well as comorbid anxiety.

3.    What is Lamictal used for?

Lamictal, or lamotrigine, is used as an anticonvulsant to treat patients with epilepsy. It is used alone or in combination with other epilepsy medications to treat seizures in adults and children. Lamictal is also used to delay mood episodes in adults with bipolar disorder. 

4.    Does Lamictal cause weight gain?

Lamictal is less likely to cause weight gain compared to other mood stabilizers. Bipolar disorder itself can increase your appetite or change your metabolism, so if you do gain weight while taking Lamictal, it is likely due to the disorder as opposed to the medication. 

Does Lamictal make you sleepy?

When you first start taking Lamictal, you may become very drowsy or sleepy. It may also be difficult to fall asleep. If you notice these symptoms are not going away while you are being treated with Lamictal, talk to your doctor or pharmacist about alternative medications. 

How quickly does Lamictal work?

It usually takes up to six weeks for Lamictal to start improving your symptoms.

Can I mix Lamictal with herbal remedies and supplements?

There might be a problem taking some herbal remedies and supplements alongside lamotrigine, especially ones that can cause rashes, sleepiness or shaking and tremors.

8.    Can Lamictal cause anger?

This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors.

9.    Can I drink alcohol on Lamictal? 

Drinking alcohol can increase your side effects from Lamictal, but drinking isn’t prohibited while you take this medication. Alcohol can also make symptoms of bipolar disorder worse directly.

10.                  Does Lamictal help with anxiety?

Lamictal (lamotrigine), a mood stabilizer and anticonvulsant, is not approved by the US Food and Drug Administration (FDA) for the treatment of any anxiety disorders, though it is approved to treat bipolar disorder and seizure disorders.

11.                  Will Lamictal affect my contraception?

The combined pill, patch and vaginal ring can lower the amount of lamotrigine in your blood, so you might want to use a different type of contraception instead.

If you decide to take the combined pill, you may need to change your dose of lamotrigine, but this depends on what other epilepsy medicines you’re taking.

12.                  Can I drive or ride a bicycle with Lamictal?

You may feel sleepy, tired or dizzy when you first start taking lamotrigine or the dose is increased. If this happens to you, do not drive, ride a bike or operate machinery until you feel more alert. It can also affect your vision. Do not drive or ride a bike if your vision is affected. If you have epilepsy, you’re not allowed to drive until you have had no seizures for one year or you only have seizures while you’re asleep.

If you want to learn more about Lamictal, epilepsy and bipolar disorders here are some reading suggestions:

Mad Like Me: Travels in Bipolar Country

Have you ever wondered what it’s like to live with bipolar disorder? Ever agonized about whether your own or a loved one’s mood swings are normal or not? This is the book for you! Mad Like Me: Travels in Bipolar Country takes you on a wild, no-holds-barred gallop through one health professional’s battles with bipolar disorder. In 2008, Dr. Hammond was struck with bipolar at age 51. Just imagine: almost overnight, she flipped from being a researcher and public health consultant to a locked-ward patient. She shares everything she learned along the way about how to reclaim your own mental health and maintain stability, and does so in an accessible, readable, often humorous way.

Wyllie’s Treatment of Epilepsy: Principles and Practice

Wyllie’s Treatment of Epilepsy: Principles and Practice, 6th edition provides a broad, detailed, and cohesive overview of seizure disorders and contemporary treatment options. Written by the most influential experts in the field and thoroughly updated to provide the most current content, Wyllie’s Treatment of Epilepsy assists neurologists and epilepsy specialists, neurology residents and fellows, and neuropsychologists in assessing and treating their epileptic patients with the latest treatment options.

Freedom From Psychiatric Drugs

A comprehensive book by Chaya Grossberg on finding freedom from psychiatric drugs.

References:

What Are Seizures? What Causes Them? – WebMD – 2019

Lamotrigine – NHS UK – February 2019

Lamictal (A complete guide)

Aura Des los Santos

Aura Des los Santos is a Clinical Psychologist with two masters degree in Education. One focused in Higher Educacion and the other in the research of Psychology of Education. Her experience is focused on working depression, anxiety and personal development. She frequently writes articles in the area of psychology, education, travel and general culture.