Lamictal

How it works

     * Lamictal is a brand (trade) name for lamotrigine which may be used
       either alone or in combination with other anticonvulsants to treat
       epilepsy. It may also be used to stabilize mood in people with
       bipolar disorder.
     * Experts are not sure exactly how lamotrigine works But some have
       suggested that it inhibits voltage-sensitive sodium channels,
       stabilizing nerve membranes and moderating the release of
       excitatory amino acids such as glutamate and aspartate.
     * Lamictal belongs to the class of medicines known as triazine
       anticonvulsants.

Upsides

     * May be used in combination with other anticonvulsants for the
       treatment of partial-onset seizures, primary generalized
       tonic-clonic seizures, and generalized seizures associated with
       Lennox-Gastaut syndrome. May be used as the sole therapy for
       treatment of partial onset seizures.
     * May be used as maintenance treatment and to stabilize mood and
       delay the occurrence of depression, mania, hypomania, or mixed
       episodes of bipolar I disorder.
     * Blood levels of Lamictal do not require monitoring.
     * Lamictal is available as a generic under the name lamotrigine.

Downsides

   If you are between the ages of 18 and 60, take no other medication or
   have no other medical conditions, side effects you are more likely to
   experience include:
     * Dizziness, coordination problems, sleepiness, headache, double or
       blurred vision, nausea, vomiting, and rash. Risk of side effects
       increases at higher dosages and with concomitant carbamazepine.
     * Rarely, life-threatening skin rashes that require hospitalization
       and discontinuation of Lamictal treatment. The risk is higher in
       younger children and possibly with higher Lamictal dosages or
       co-administration with valproate. Most, but not all, cases occur
       within two to eight weeks of treatment initiation. Lamictal may
       also cause a benign, non-problematic rash and distinguishing
       between different rashes caused by Lamictal may be difficult. Seek
       urgent medical advice at first sign of a rash with Lamictal, unless
       the rash is clearly not drug-related. Discontinuation of Lamictal
       may be needed.
     * Rarely, potentially fatal hypersensitivity reactions may also
       occur. Seek medical advice with any sign of fever or swollen lymph
       nodes.
     * As with other anti-epileptics, Lamictal may increase the risk of
       suicidal thoughts or behavior; monitor for worsening depression or
       mood changes.
     * May interact with several drugs including other anticonvulsants
       (such as carbamazepine and phenytoin), estrogen-containing oral
       contraceptives, and some HIV antivirals.
     * Rarely, has been associated with sudden unexplained death.
     * Caution may be needed when using in people with renal or hepatic
       impairment and some other medical conditions.

   Notes: In general, seniors or children, people with certain medical
   conditions (such as liver or kidney problems, heart disease, diabetes,
   seizures) or people who take other medications are more at risk of
   developing a wider range of side effects. For a complete list of all
   side effects, [84]click here.

Bottom Line

   Lamictal is used to decrease the frequency and severity of seizures in
   some types of epilepsy and also to stabilize mood in bipolar disorder.
   Rarely, Lamictal may cause a potentially fatal rash requiring immediate
   drug discontinuation.

Tips

     * May be taken with or without food. If you develop a stomach upset
       after taking Lamictal, taking it with food may help.
     * Lamictal chewable dispersible tablets may be swallowed whole,
       chewed or dispersed in water or dilute fruit juice. Lamictal orally
       disintegrating tablets should be placed on the tongue and moved
       around the mouth. Do not attempt to administer partial quantities
       of the dispersed tablets.
     * Take exactly as directed by your doctor. Do not stop taking
       Lamictal suddenly without your doctor's advice. The dosage will
       need tapering off on discontinuation as directed by your doctor.
     * May cause drowsiness and affect your ability to drive or operate
       machinery. Avoid alcohol.
     * Risk of rash may be decreased by lower starting dosages and a
       slower upward titration of dose as prescribed by your doctor. If
       possible (unless safety concerns dictate otherwise), Lamictal
       should be discontinued in a step-wise fashion (suggested decrease
       50% per week) over at least two weeks.
     * Seek urgent medical advice if you develop a severe rash or reaction
       after taking Lamictal. Symptoms may include red, swollen,
       blistered, or peeling skin (with or without fever); red or
       irritated eyes; or sores in your mouth, throat, nose, or eyes. The
       risk of a severe skin reaction is greater in children aged 2 to 17
       years; when taken in conjunction with valproate, with higher
       dosages of Lamictal, or if the dosage of Lamictal is increased too
       fast.
     * The extended-release form, Lamictal XR, should only be used in
       adults and children aged 13 years or older. The immediate release
       form (Lamictal, Lamictal ODT) can be used in children aged 2 years
       or older as long as it is used in combination with other seizure
       medications. When used alone, this form can only be used in adults
       and teenagers over the age of 16.
     * May interfere with some hormonal contraceptives. Let your doctor
       know if you are taking birth control.

Response and Effectiveness

     * Lamictal is rapidly absorbed and peak levels are reached within 1.7
       to 4.8 hours of administration. The effects of Lamictal last for
       over 24 hours and once-daily dosing is often prescribed. However,
       some doctors prefer to split the dose to decrease the risk of side
       effects such as drowsiness.

References