Lamotrigine (Lamictal)
Lamotrigine is another mood-stabilizing, antiseizure medication that is an effective treatment for bipolar disorder. Lamotrigine works by blocking glutamate, an important neurotransmitter biochemical in the brain. As a mood stabilizer, Lamictal treats the core pathology of bipolar disorder and so it reduces all bipolar symptoms. In addition, it helps reduce the production of stress hormones.
Lamictal is a good general mood stabilizer that reduces the symptoms of bipolar mania and depression. However, it is not clear that lamotrigine can block a cycle of depression from starting. After bipolar depression has already started, it may be too late to reverse it completely.
Lamotrigine comes in regular and chewable tablets.
How do you decide when to prescribe lamotrigine?
I have had the best luck with lamotrigine when it is added to a major mood stabilizer. It is also useful in individuals who have failed with a major mood stabilizer or who cannot tolerate giving blood for blood tests.
What are the usual side effects of Lamotrigine?
One recent study found that the most common side effects after taking lamotrigine were headache and nausea. Those were the same symptoms commonly reported by control patients taking a placebo.
As with some other medicines, some people can get a rash with red bumps and blisters that usually do not hurt or itch. This rash is more prevelent when doses are raised rapidly. If this lamotrigine rash persists, it can become severe or even fatal. For this reason, doctors usually tell their patients to stop lamotrigine if they get a rash and either call or come for an appointment right away.
How do you dose lamotrigine?
Current licensing suggests starting at a low dose and increasing slowly every week. Ever since doctors began to raise lamotrigine doses slowly, there have been few cases of the rash.
Lamotrigine can interact with some other medications to change their levels in the blood. For this reason, doctors are advised to use a lower lamotrigine dose if they are combining lamotrigine with valproate, and to use a higher lamotrigine dose when combining with carbamazepine. Check with your doctor and see what she or he recommends.
Will lamotrigine give me energy?
My patients tell me that lamotrigine is not sedating in any way. Some of them say they have increased activation and more motivation without manic symptoms.
Does lamotrigine cause weight gain?
Unlike carbamazepine, valproate, or lithium salt, Lamotrigine does not cause weight gain in my patients. A number of my patients have even lost weight while taking lamotrigine.