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LaMICtal
Lamictal, the brand name for lamotrigine, is an anticonvulsant or antiepileptic medication used to treat seizure disorders and bipolar disorder. It works by stabilizing electrical activity in the brain and is commonly prescribed for the treatment of partial seizures, tonic-clonic seizures, and bipolar depression. In patients with bipolar disorder, Lamictal helps reduce the frequency of mood swings and prevents the occurrence of depressive episodes.
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Frequently Asked Questions
How long does it take for LaMICtal to start working?
LaMICtal may take several weeks to reach its full effect, particularly for bipolar disorder. For epilepsy, the effects on seizure control can be seen once the therapeutic dose is reached, which may take a few weeks due to the need for slow dose titration.
Can I stop taking LaMICtal if I feel better?
No, do not stop taking LaMICtal without consulting your doctor. Stopping the medication suddenly can lead to increased seizure activity or a return of bipolar symptoms.
What should I do if I miss a dose of LaMICtal?
If you miss a dose, take it as soon as you remember, unless it’s close to the time for your next dose. Do not double up on doses. If you miss several doses, contact your doctor before restarting the medication, as you may need to start the titration process again.
Is LaMICtal safe during pregnancy?
LaMICtal can be used during pregnancy if the benefits outweigh the risks, but it may increase the risk of certain birth defects. Discuss with your doctor if you are pregnant or planning to become pregnant.
Can LaMICtal cause weight gain?
LaMICtal is less likely to cause weight gain compared to other antiepileptic drugs, but individual responses may vary.
Comprehensive Drug Guide
How Does LaMICtal Work?
Lamictal works by inhibiting the release of glutamate, a neurotransmitter that plays a key role in triggering seizures and mood episodes in bipolar disorder. It stabilizes the electrical activity in the brain, helping to prevent the onset of seizures and reducing abnormal brain activity that can lead to mood swings in bipolar disorder. By modulating voltage-sensitive sodium channels, Lamictal reduces the excessive excitatory signals in the brain.
Common Dosages
- 25 mg, 50 mg, 100 mg, 150 mg, 200 mg tablets
- Chewable dispersible tablets (25 mg, 50 mg)
- Orally disintegrating tablets (25 mg, 50 mg, 100 mg, 200 mg)
The dosing schedule is typically titrated slowly to reduce the risk of side effects, particularly serious skin reactions.
Typical Dosing
- For epilepsy: The starting dose for adults is 25 mg once daily for 1 to 2 weeks, gradually increasing to a maintenance dose of 100 mg to 400 mg per day based on individual response and other medications being used.
- For bipolar disorder: The initial dose is 25 mg once daily for 2 weeks, then gradually increased over several weeks to a typical maintenance dose of 100 mg to 200 mg daily.
Dosing adjustments are necessary when Lamictal is used in combination with other medications, such as valproate or enzyme inducers like carbamazepine.
Typical Dosing
FDA Approved Indications
- Treatment of epilepsy in adults and children, including partial seizures, tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome.
- Maintenance treatment of bipolar disorder, particularly to prevent depressive episodes in adults.
Who Shouldn't Take LaMICtal?
- Known hypersensitivity or allergy to lamotrigine or any component of the formulation.
- Previous history of serious skin reactions, such as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN), with lamotrigine.
Advice From The Pharmacist
- Take Lamictal as prescribed, and do not adjust your dose without consulting your doctor. Titrating the dose slowly is important to reduce the risk of serious skin reactions.
- Do not stop taking Lamictal suddenly, especially if you're using it for seizures, as this can increase the risk of seizure activity. If discontinuation is necessary, your doctor will gradually reduce the dose.
- If you experience symptoms of a serious rash, such as skin peeling or blistering, stop taking the medication and seek medical attention immediately.
- Use caution when engaging in activities that require mental alertness, such as driving, until you know how Lamictal affects you.
- Store Lamictal at room temperature and keep it out of reach of children.
Side Effects of LaMICtal
Common Side Effects
- Dizziness
- Headache
- Blurred vision
- Nausea
- Drowsiness
- Tremors
Uncommon/Severe Side Effects
- Severe skin reactions such as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN)
- Liver problems, indicated by yellowing of the skin or eyes (jaundice)
- Suicidal thoughts or behaviors, particularly in the early stages of treatment
- Blood disorders, such as low white blood cell counts
Risks and Warnings of LaMICtal
- Serious Skin Reactions: Lamictal can cause life-threatening skin reactions such as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). These reactions are more likely to occur in the first 2 to 8 weeks of treatment. Discontinue use immediately if any signs of rash, blistering, or skin peeling occur.
- Suicidal Thoughts: Like other antiepileptic drugs, Lamictal carries a risk of increasing suicidal thoughts and behaviors. Patients should be closely monitored for any changes in mood, behavior, or suicidal ideation.
- Drug Interactions: Lamictal interacts with several other medications, including valproate, which increases the risk of side effects, and enzyme inducers such as carbamazepine, which can lower lamotrigine levels.
Interactions with LaMICtal
Common Drug Interactions
- Valproate (Depakote): Increases lamotrigine levels, raising the risk of side effects, particularly serious skin reactions.
- Carbamazepine (Tegretol), phenytoin (Dilantin), and phenobarbital: These drugs can lower Lamictal levels in the blood, reducing its effectiveness.
- Oral contraceptives: Hormonal contraceptives can reduce the effectiveness of Lamictal, and Lamictal can affect hormone levels, potentially reducing contraceptive efficacy.
Alternatives to LaMICtal
- Depakote (valproic acid): Another anticonvulsant used for seizures and bipolar disorder.
- Carbamazepine (Tegretol): An anticonvulsant and mood stabilizer commonly used for epilepsy and bipolar disorder.
- Topamax (topiramate): An anticonvulsant used for epilepsy, migraines, and sometimes for bipolar disorder.
- Lithium: A traditional mood stabilizer used to manage bipolar disorder.
