Lamotrigine
Lamotrigine (marketed as Lamictal by GlaxoSmithKline) is marketed as both an anti-epileptic medication and a treatment for bipolar disorder. For epilepsy it is used to treat partial seizures, primary and secondary tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome. It is typically taken in combination with other epilepsy medications.
As with a handful of anti-convulsants and anti-epileptic medications, Lamotrigine can also be used as a mood stabilizer. It has demonstrated some effectiveness as an antidepressant.
Lamotrigine has known side effects which are rare, yet serious. The manufacturer advises that patients begin at a low introductory dose of the medication and increase it slowly over time to the therapeutic dose in order to minimize these side effects. This method of dose adjustment is called titration. It may take a patient weeks or even months to titrate to the target dose. To avoid negative side effects the dose of Lamictal should not be abruptly increased or decreased. As per the manufacturer, if a patient misses a dose, that dose can still be taken unless it is close to the time for the next dose. Patients are advised to never double a dose.
Lamotrigine is manufactureed in 25mg, 50mg, 100mg, 150mg and 200mg tablets. Patients are typically started on 25mg dosages. Some patients report antidepressant effects at the lowest dosages ranging up to 200mg. Clinical studies have not shown any additional anti-depressive effect at dosages beyond 200mg. Mood stabilizing effectiveness of Lamotrigine takes place in the 100mg - 200mg range. According to the manufacturer the maximum dose is 200mg though some mental health providers prescribe higher doses for their patients for the treatment of manic symptoms.
Lab testing may be ordered by the prescribing physician to monitor blood concentration levels of Lamotrigine.
Side Effects
Common side effects include headaches, dizziness and insomnia. In rare cases, Lamotrigine has been known to cause the developement of a dangerous rash in some people called Stevens-Johnson syndrome. The rash is more common in children, so this medication is often reserved for adults.
Drug Interactions
Other medications can increase or decrease the effectiveness of Lamotrigine for the treatment of bipolar disorder. For patients taking valproic acid (Depakene), divalproex sodium (Depakote), or valproate sodium (Depacon) the dosage of Lamotrigine requires decreasing to reach the same level of effectiveness due to drug interactions. For patients taking phenytonin (Dilantin), oxcarbazepine (Trileptal), or carbamazepine USP (Tegretol) the dosage of Lamotrigine needs to be increased to reach the same level of effectiveness.