ADHD Medication and Treatment Reviews

Lamictal

Lamictal is a medication used to treat epileptic seizures and also mood episodes in adults with bipolar disorder. Learn about its uses, side effects, dosages, and warnings here. Generic Name: lamotrigine

By Janice Rodden
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What is Lamictal?


Lamictal (Generic Name: lamotrigine) is an anti-convulsant medication prescribed in tandem with other medications to prevent and control epileptic 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 anti-epileptic 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.

Dosage for Lamictal

Lamictal is available in several formulations and dosages:

  • 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 of 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.

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.

What Are the Most Common Side Effects of Lamictal?

Most people taking Lamictal do not experience side effects. That said, the most common side effects of Lamictal are as follows:

  • dizziness
  • headache
  • blurred or double vision
  • decreased motor coordination
  • sleepiness or difficulty sleeping
  • nausea
  • vomiting
  • tremors
  • rash
  • fever
  • abdominal pain
  • dry mouth

Lamictal and Seizures

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.

Lamictal and Allergic Reactions

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.

Tell your doctor if you are taking valproate (valproic acid or Depakene). 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.

Lamictal and Driving

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.

Lamictal and Familial Mental Health

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.

Lamictal and Meningitis

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 Associated with Lamictal


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 anti-seizure 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.

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.

Interactions Associated with Lamictal

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.

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

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.

Lamictal and Other ADHD Medications: More Information

Sources:

Lamictal. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/022251,020764s029,020241s036lbl.pdf

Bowden, Charles L. Lamotrigine (Lamictal IR) for the treatment of Bipolar Disorder. Expert Opinion on Pharmacoptherapy. (2012) https://www.tandfonline.com/doi/abs/10.1517/14656566.2012.741590