What is Lamotrigine?
Lamotrigine is a prescription drug that belongs to a class of drugs known as anticonvulsants or antiepileptic drugs (AEDs) [1]. It has multiple formulations, all of which can be taken orally, either as immediate-release oral tablets, extended-release tablets, chewable or orally disintegrating tablets [2]. The formulation you take should have minimal impact on its efficacy for treating your underlying symptoms. Still, immediate-release tablets may be essential if you wish to have immediate symptom relief, such as in acute seizures [2].
Uses of Lamotrigine
Lamotrigine is a prescription medication used for a spectrum of neurological and mental health conditions. It is primarily used to treat seizures in people with seizures and Lennox Gastaut Syndrome [3, 4, 2]. For seizures, it is usually combined with anti-epileptic drugs, such as carbamazepine, valproic acid, ritonavir or phenobarbital.
Other off-label uses include:
- as a mood stabilizer in bipolar disorder [5]
- binge eating disorder
- basilar migraine with aura [6]
- panic disorder
- trigeminal neuralgia [6]
The mechanism through which lamotrigine works is not fully clear. It acts on voltage-gated sodium channels that regulate neural activation and hence can regulate the brain's overall activation and synchrony.
Lamotrigine and ADHD
ADHD is the common abbreviation for Attention Deficit Hyperactivity Disorder, a condition characterized by inattention, hyperactivity, and difficulty focusing. It is conventionally managed by stimulant medication, including Adderall and Ritalin [7].
Can Lamotrigine Alleviate Symptoms of ADHD?
Lamotrigine has been studied for a spectrum of neurological and mental health conditions due to its universal activity on sodium channels in the brain. The use of lamotrigine by individuals with ADHD and comorbid mood disorders was examined in a 2014 study by Bedriye Öncü et al. These patients were using lamotrigine for mood disorder and 31 out of the 40 patients sampled observed improvement in their mood symptoms while taking lamotrigine.
However, this study did not examine changes in ADHD symptoms, hence it is not possible to deduce whether lamotrigine affects ADHD [8]. It is also important to note that these patients were taking antidepressant and anticonvulsant medication on top of lamotrigine, making the effects of lamotrigine challenging to isolate.
Lamotrigine in Pediatric Patients with ADHD
In contrast to the above study in adults, pediatric patients taking lamotrigine for epilepsy and concurrently diagnosed with ADHD showed improvements in their ADHD scores. Specifically, 87% of the 31 patients with epilepsy and comorbid ADHD saw improvements in their ADHD scores [9]. Another study involving children with paroxysmal kinesigenic dyskinesia (PKD) found that a two-year lamotrigine treatment resulted in improvements in ADHD symptoms, particularly inattentiveness. The team, however, also found that the children with ADHD took longer to show improvements in their PKD symptoms than children without ADHD [10].
These two studies indicate that the comorbid disorder you have been prescribed lamotrigine for may be predictive of whether or not your ADHD symptoms improve. Likewise, lamotrigine may not be helpful for adult ADHD. This could be because, for instance, reducing your epilepsy symptoms also reduces ADHD symptoms, but lowering symptoms of mood disorders has no impact on symptoms of ADHD.
However, more research is needed to confirm these findings and understand the exact mechanisms involved. Taking lamotrigine if you have ADHD is not advised unless you have been prescribed lamotrigine by your medical provider for a comorbid disorder.
Can Lamotrigine Cause ADHD?
Whether lamotrigine can cause ADHD is a topic of more significant concern for healthcare providers and people who have been prescribed lamotrigine.
A large-scale study of mothers who took lamotrigine and related anti-epileptic drugs in pregnancy found that lamotrigine did not increase the risk of their child developing ADHD symptoms [11]. However, the combination of lamotrigine and valproate did increase the risk of the child having autism, but this may be primarily attributed to valproate. This was confirmed by a recently published meta-analysis, which considered in-utero exposure to lamotrigine safe for the child's development [12].
Lamotrigine is also commonly prescribed to children with epilepsy at a young age, which is also the peak age at which ADHD symptoms develop and are noticed. However, no study to date has looked at whether children prescribed lamotrigine for epilepsy are more likely to develop ADHD.
In the study where children with PKD were prescribed lamotrigine, children who took longer to see improvements in their PKD symptoms after taking lamotrigine were more likely to be consequently diagnosed with ADHD. However, this does not imply a causative relationship between lamotrigine use and ADHD.
Summary: Lamotrigine for ADHD
To summarise, lamotrigine is a neuroactive prescription medication used for epilepsy, bipolar depression, and bipolar II, as well as neuropathic pain. It is not linked to changes in ADHD symptoms in adults, with limited efficacy in reducing inattentiveness in children with ADHD. If you have ADHD, you must discuss treatment options with a healthcare provider. Suppose you are being prescribed lamotrigine for a co-occurring condition. In that case, you must inform your healthcare provider of any other medications or supplements you are taking, as well as any pre-existing medical conditions. This is to ensure you don't experience serious drug interactions.