Lamictal (lamotrigine): Uses, Side Effects, Dosage

Lamictal (lamotrigine) is an anticonvulsant prescription drug for bipolar disorder that’s well-tolerated by many people who take it. It’s known for its ability to delay the time between bipolar depressive episodes. It’s important to learn more about how this medication works and discuss with your doctor before deciding to take Lamictal.

Read on to learn how you’ll feel when taking Lamictal, what Lamictal treatment is used for, pros and cons, common side effects and dosage information, how to take it, considerations to keep in mind, and alternatives you might consider. We’re covering everything you need to know about Lamictal medication for bipolar disorder here. 

What is Lamictal? 

Lamictal is an FDA-approved medication used to treat seizure disorders like epilepsy along with mood disorders such as bipolar. It’s also used off-label — meaning the FDA hasn’t approved it but may effectively treat — unipolar depression (also known as a major depressive episode). 

Lamictal for bipolar disorder can be a critical part of your comprehensive treatment plan. It’s worth considering if you’re thinking about starting Lamictal treatment or changing your bipolar medication. 

How does Lamictal work?

Unfortunately, we don’t know exactly how or why Lamictal medication works to improve bipolar depression. It’s thought to impact and stabilize electrical activity in the brain, which might help prevent mood swings or delay the time between depressive mood episodes. 

Lamictal seems to be more effective in treating the depressive symptom manifestations of bipolar disorder than it is in treating mania. 

How does Lamictal make you feel?

Lamictal can decrease excitability and offer feelings of emotional steadiness. Some people experience drowsiness or sleepiness when they first start taking a Lamictal or Lamotrigine dose. These are common possible effects, and they’re generally mild, but if they’re interfering with your ability to function daily, they can often be addressed through dosage adjustment. 

For many people, Lamictal is life-changing. It can significantly reduce mood fluctuations and improve emotion control. 

Lamictal Uses

Lamictal for depression experienced with bipolar can be effective, and the prescription drug can also be used for maintenance. It’s the only mood-stabilizing drug for bipolar that works by reducing depression instead of controlling mania, making it an excellent option when depressive symptoms are more prevalent than mania. 

There are also additional off-label Lamictal uses. 

Lamictal for Bipolar I disorder maintenance

Lamictal can reduce depressive episodes associated with bipolar disorder by delaying the next occurrence. Thus, it’s the prevention aspect of this specific drug that may offer the most significant impact in controlling bipolar depression. 

Lamictal off-label for unipolar depression or chronic depression

Some recent research shows that Lamictal might be a good option for people with persistent depressive disorder (PDD) — also known as dysthymic disorder — when other antidepressants or forms of treatment haven’t helped. Other studies suggest Lamictal can significantly improve treatment-resistant unipolar depression.

Lamictal off-label for anxiety

While it’s not FDA-approved for anxiety treatment, in one study, Lamictal showed promising results in reducing stress and symptoms of chronic anxiety. More research is needed, but a Lamictal or Lamotrigine dose might be an effective off-label anxiety treatment option for some people. 

Pros & Cons of Lamictal

Like any medication, there are pros and cons to Lamictal. It’s important to use caution and understand both the benefits and the risks before you decide to take any drug.

Pros of LamictalCons of LamictalBalances emotionsPotential for severe side effects and severe skin reactionsGenerally well-tolerated by most and fast-actingDosage must be slowly increased to prevent risk of adverse reactions, potentially taking longer to see resultsNot a high risk of weight gainDoesn’t prevent or treat maniaCan delay time between mood change episodesNot suggested for treating bipolar in children or adolescents 

“Lamictal is an excellent choice for mood disorders, as there is no weight gain or metabolic concerns compared to other medications. It can easily be combined with other psychotropic medications like SSRIs or SNRIs to address mood, liability, agitation, and irritability.”

– Talkspace psychiatrist Dr. Muhammad Munir, MD

Side Effects of Lamictal

All drugs, including Lamictal, have a risk of severe or mild side effects. Understanding potential reactions to a new medication is important so you know what’s common, rare, or possibly life-threatening.

Common side effects of Lamictal include:

Drowsiness

Nausea or vomiting  

Changes in urination output

Tightness in the chest

Changes in vision including blurred or double vision

Feeling more clumsy, unsteady, or uncoordinated than normal

Irregular heartbeat

Increased sweating

Pain in the jaw

Change in breathing pattern

Arm, back, or neck pain

Dilated neck veins

Rash

Swelling in the face, lower legs or feet, and fingers

*Note this list is not all-inclusive

Less common, but still notable, mild side effects of Lamictal might include:

Anxiety

Depression or increased irritability

Chest pain

Uncontrollable or continuous eye movement

Confusion 

Increased seizures

Infection 

*Note this list is not all-inclusive

Lamictal has the potential for severe, possibly life-threatening, side effects that you should be aware of: 

Stevens-Johnson Syndrome (SJS)

Toxic Epidermal Necrolysis (TEN)

Hemophagocytic lymphohistiocytosis (HLH)

Aseptic meningitis

Multiorgan hypersensitivity reactions

Angioedema 

Increased thoughts of suicide

Serious allergic reaction

Lamictal Dosage

To prevent serious side effects, Lamictal dosage needs to be slowly increased over time. Because of this, most doctors will start you on a very low dose. 

Lamictal is typically prescribed to treat bipolar depression in doses ranging from 25mg to 400mg. Your healthcare provider or doctor will likely increase your dose every 1 – 2 weeks until Lamictal works and you achieve optimal results. It can take weeks to months before you find the dosing schedule that’s most effective in treating your specific bipolar symptoms.  

There are several forms of Lamictal, including: 

Chewable tablets

Tablets

Orally disintegrating

Extended-release

How to take Lamictal

Always take Lamictal exactly as directed by your doctor or healthcare provider and use caution. Never abruptly discontinue Lamictal without discussing a safe taper plan with your doctor, medical professional, or psychiatrist first. 

Take tablets whole; do not crush them. Dissolvable tablets may be dissolved in liquid, chewed, or swallowed whole. Lamictal can be taken with or without food. 

If you forget or miss a dose of Lamictal, take it as soon as you remember, unless it’s close to the time you’d take it again. In that case, just skip the missed dose and resume with your next scheduled one. Never double-dose Lamictal. 

If you accidentally take too much Lamictal, immediately call your doctor, 911, or poison control at 800-222-1222. You can also go to your nearest emergency room. 

Additional Considerations

Lamictal can be an effective option for bipolar depression treatment, but there are some considerations to note before deciding to take this drug. 

“One has to be extra careful when starting Lamictal and adjusting the dose. It’s essential to follow the instructions and make sure not to miss the dose of the medication as that can be very detrimental to the treatment and can cause serious side effects, including having a seizure.”

– Talkspace psychiatrist Dr. Muhammad Munir, MD

Drug Interaction

Lamictal is known to interact with certain medications. To ensure Lamictal is safe for you, it’s essential to inform your doctor of everything else you take — including other prescription drugs, vitamins, and supplements, even if they’re over-the-counter. 

Lamictal can interact with more than 280 other drugs, including but not limited to:

Adderall

Ativan

Ambien

Birth control

Gabapentin

Ibuprofen

Lexapro

Metformin

Prozac

Xanax

Zyrtec

*Note this drug interaction list is not all-inclusive

Warnings

Lamictal can cause serious skin reactions that may need immediate care. In some cases, they can be fatal. The likelihood of experiencing a severe Lamictal-related skin reaction increases when the dosage is too high or if there’s a rapid increase in dose. This is why ramping up the dosage must be done slowly and under diligent observation. 

Be sure to report any skin changes you notice if you’ve just started Lamictal or your doctor recently changed your dose.

Lamictal Alternatives

Although it can be quite effective in treating depressive symptoms in bipolar disorder for many people, Lamictal is not suitable for everyone. Fortunately, there are alternatives you can try if you haven’t responded well to Lamictal or if you’re experiencing adverse or intolerable side effects. 

Depakote (divalproex sodium): Often used in bipolar disorder management, Depakote can be effective in helping to stabilize mood swings.

Lithium: A first-line treatment for bipolar disorder, Lithium has been used for decades to help prevent both manic and depressive episodes associated with bipolar disorder. Learn how Lamictal compares to Lithium to make an informed decision.

Zyprexa (olanzapine): This antipsychotic medication is prescribed for both schizophrenia and bipolar I disorder maintenance. Though widely used, it comes with potential side effects that require careful monitoring by your doctor. 

Online Lamictal Prescription Through Talkspace 

Talkspace can help you get prescriptions for bipolar medications like Lamictal online. The convenience of the online platform makes getting medication an efficient, affordable, and secure process. Talkspace connects you with licensed mental health professionals to help you find the right treatment plan to reduce or resolve symptoms of bipolar disorder

Talkspace providers can offer therapy for bipolar disorder, prescribe medications, and provide ongoing medication management to ensure you’re getting optimal results and living your best life. 

Learn how to get Lamictal prescribed by an online psychiatrist today.