What is Lamotrigine?
Lamotrigine, often known by the brand name Lamictal, is a second-generation antiepileptic drug (AED) used primarily to treat epilepsy, partial seizures and gestaut syndrome [1, 2]. Its relatively new pharmacology is different from conventional antiepileptic drugs such as benzodiazepines. Lamotrigine works by blocking voltage-sensitive sodium channels, which decreases brain activity by blocking the release of excitatory neurotransmitters [3].
The lamotrigine oral tablet is effective in patients with different types of epilepsy, who did not always benefit from benzodiazepines and other conventional anti-epileptic drugs [3].
The mean therapeutic dose of lamotrigine is 200 - 400 mg/day [4].
Benefits of Lamotrigine
Lamotrigine has a favorable side-effect profile and more straightforward dosing than earlier drugs [1]. It has a longer half-life, which can be beneficial because you don't have to take multiple doses.
In addition to its use in epilepsy, lamotrigine has also been used as a long-term treatment for bipolar disorder or bipolar depression. This is mainly for Bipolar II, which is characterized by a more frequent occurrence of depressive rather than manic episodes [5].
Side Effects of Lamotrigine
Lamotrigine can cause a range of side effects, from mild to serious. If the side effects impact your daily activities and well-being, it is very possible for lamotrigine to ruin your life.
Common side effects of lamotrigine include:
- Skin rashes, occuring in about 5% of patients. A skin rash is the most common side effect, arising from an immune system reaction to lamotrigine, similar to an allergic reaction. The incidence of rash can be reduced by starting treatment with a low dose, particularly in patients receiving concomitant sodium valproate, which inhibits lamotrigine metabolism [6].
- Nausea
- Vomiting
- Blurred vision
- Double vision, scientifically called diplopia, or vision abnormalities in general [7].
Other side effects can include headache, dizziness, ataxia (loss of control of bodily movements), and tremors [6].
A rare side effect of lamotrigine is Stevens-Johnson syndrome (SJS), a life-threatening, blistering mucocutaneous disease [8]
- Suicidal thoughts
Can Lamotrigine Ruin Your Life?
Lamotrigine, an anticonvulsant and mood stabilizer, is generally well-tolerated and can significantly improve the quality of life for individuals with epilepsy and bipolar disorder [9, 10]. However, like any medication, it can have adverse effects that, in rare cases, may be severe and potentially life-threatening.
One of the most severe side effects of lamotrigine is the development of life-threatening rashes, such as Stevens-Johnson syndrome (SJS). SJS is a blistering mucocutaneous disease that involves less than 10% of the body's surface area and can occur at any time but is most likely within the first 2 to 8 weeks of starting the drug [11, 8].
In rare cases, lamotrigine can cause severe and potentially lethal arrhythmias, especially in patients with underlying cardiac disease or those taking medications that affect heart conduction [12].
Lamotrigine has also been associated with the development of mental health problems, including the rare development of psychotic disorders, mainly when used concurrently with other medications that may impact its metabolism [13, 14]. This is particularly relevant if you are taking anticonvulsants such as valproate or carbamazepine with lamotrigine for epilepsy or antidepressants for bipolar II.
If you overdose on lamotrigine, there is a high risk of toxicity, including seizures, movement disorders of loss of consciousness. Overdosing on lamotrigine can also impact your cardiovascular health by causing irregular heartbeat [15].
While these side effects can be severe, it's important to note that they are relatively rare. Most patients tolerate lamotrigine well, which can significantly improve their quality of life. However, seeking medical advice immediately is crucial if you find that lamotrigine negatively impacts your health and well-being.