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Uses and Effects of Lamictal

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In this article, we will introduce you to the uses and effects of Lamictal, and try to answer some of the more frequent questions that people ask us about it.  Lamictal (generic name: lamotrigine) is a chewable pill that can help prevent epileptic seizures and cycles of depression. It works by stabilizing electrical activity in the brain. 

Lamictal as treatment in epilepsyOpen hand with medicine pill.

Lamictal is what is known as a sodium channel inhibitor. It works by inhibiting the voltage-dependent sodium channels in neurons and decreases the release of glutamate and aspartate. Glutamate and aspartate are the primary excitatory transmitters in nerve signaling.

Lamictal is available in the form of an immediate-release formulation and as extended-release tablets. It was first approved in 1994 for treating recurrent seizures that begin early in life, known as Lennox-Gastaut syndrome.

For younger patients when there has been inadequate seizure control, physicians can prescribe additional anti-epileptic medications to control seizures better. The choice of which drugs to use in combination with lamotrigine will depend on the individual patient’s condition and their specific type of epilepsy. Commonly used anti-epileptic drugs in combination with lamotrigine include valproic acid, carbamazepine, phenytoin, and topiramate.

More recently, Lamictal extended-release tablets have been approved by the FDA as an add-on therapy for epilepsy in patients who are aged 13 years and older and suffer from primary generalized tonic-clonic seizures. 

Lamictal may also be prescribed as a monotherapy for adult and teenage epileptic patients. Monotherapy has many advantages for epileptics, such as fewer adverse events, better tolerance, avoidance of drug interactions, and improved compliance. Monotherapy is usually the preferred initial treatment for adults.

Lamictal and bipolar I disorder

Bipolar I disorder is a form of mental illness in which a person displays several periods of abnormally elevated or irritable moods, in a cycle with episodes of deep depression. Sometimes, the term used to describe the disorder is “manic depression” to indicate the swings between the two extremes.

Manic episodes in bipolar I disorder require treatment with drugs like mood stabilizers and anti-psychotics to control manic phases. The most widely used anti-psychotic is Lithium (Eskalith, Lithobid), which effectively controls mania that involves classical euphoria but is not effective for depression. Lithium can take weeks to work fully, making it preferred for maintenance treatment rather than for sudden manic episodes. 

Lamictal is especially effective in treating depression. Lamictal can be an excellent choice because it can be prescribed either in extended-release (LTG-XR) form, which is good for long-term maintenance, or immediate-release lamotrigine (LTG-IR), when the patient’s levels of depression are deep, or the threat of suicide becomes more real.

Another benefit of using Lamictal to treat bipolar disorder in children and teenagers is that the drug has been shown to have a protective effect against suicidal behavior in younger patients, whereas some other medications used to treat bipolar disorder have been associated with an increased risk of suicide.

Dosage and side-effects

Lamictal is a drug of choice because it comes in two forms – immediate-release and extended-release. It is also favored because the range of dosages is very wide, coming from 5 mg all the way up to 200 mg. This enables very accurate control of the dosage to suit each patient’s needs.

Each patient’s history, age, general health and the nature of the disorder will affect the recommended dosage, based on the uses and effects of Lamictal. The prescribing healthcare professional will explain the proper way and form of treatment.

Unlike many other drugs that treat neurological or psychological disorders, there have been no reported reasons that it is necessary to avoid Lamictal and alcohol intake while under treatment. So far, nothing has indicated that a reasonable intake of alcohol will have any negative outcome by changing the drug’s intended effects.

Lamictal has a relatively low risk of causing side effects. Common side effects of lamotrigine are generally mild and go away on their own. If they persist or get worse, consult soon with your healthcare provider or pharmacist. These include feeling unexpectedly drowsy, sleepy or dizzy; feelings of aggression, irritability or agitation; shaking or tremors; and difficulty sleeping.

Some other side effects could be similarly transient, but these need to be followed carefully as they may be indicators of more serious developments. Headaches; diarrhea, nausea or vomiting can in rare cases be signs of aseptic meningitis. 

A skin rash can be an indication of a serious, life-threatening condition known as Stevens-Johnson syndrome. It can start with flu-like symptoms, followed by a painful rash that spreads and blisters. 

If such symptoms present together and persist, it is essential to stop treatment and go immediately to an emergency healthcare facility with details of the medications being taken.

FAQblue question mark on pink background

What are the differences in uses and effects of Lamictal and lithium as treatments for bipolar I disorder?

The most frequently asked questions about Lamictal deal with its comparative benefits. Lamictal and lithium are adjunctive treatments for bipolar I conditions. For this reason, people can get confused about their relative roles. Lithium is intended to treat manic phases in bipolar disorder, whereas Lamictal treats depression. 

Is Lamictal better than lithium?

Other ways of phrasing this question are “do I need to make a choice of either Lamictal or lithium?” or “is it always a matter of Lamictal versus lithium?”). However, the two drugs have different purposes and work best together to address the different aspects of bipolar I disorder.

Do clinical studies of the uses and effects of Lamictal versus Depakote show any significant advantage to either?

Both drugs are prescribed for epilepsy as well as bipolar I disorder. Based on ratings of customer satisfaction, Depakote ranks slightly lower (3.3 out of 5 average rating) than Lamictal (3.7 out of 5 average rating). However, the final choice between them should be made by your healthcare professional, who will take all the relevant aspects into account.

Why do doctors choose Lamictal or Abilify (aripiprazole)?

The differences between the two drugs are more substantial than between Lamictal and lithium. Lamictal is an anticonvulsant whereas Abilify is an antipsychotic. Abilify is used to treat schizophrenia, manic-depression, autistic disorder, and some irritable behavior disorders, but not epilepsy.

Does Lamictal cause weight gain? 

Unlike some other medications used to treat bipolar disorder, Lamictal does not typically cause weight gain, which can be a concern in young patients.

Is there a role for Lamictal in the treatment of autism?

It’s too early to answer the question of the uses and effects of Lamictal in treating autism. It is the subject of current research, but only recently have any studies made any strong connection. For example, in February 2023, one study found that lamotrigine had a role in reversing autism in mice. It will take many years of further investigation before this connection could turn out to be of therapeutic value.

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