Lamictal Index | Brand and Generic Availability ›
Crazy Meds Comprehensive Lamictal pages

This is our basic overview of Lamictal (lamotrigine). Clicking on a “More…” link will take you to a page with greater detail. The Comprehensive Lamictal pages contain all of the information from all of the “More…” pages, but with less explanatory material.

1.  Brand & Generic Names; Drug Class

US brand name:	Lamictal
Generic name:	lamotrigine
What is Lamictal (lamotrigine)?	Lamictal (lamotrigine) is in the AntiepilepticDrugs/Anticonvulsants class of drugs.

More about Lamictal’s generic availability, worldwide trade names, and more

2.  What is Lamictal (lamotrigine) used for

2.1  US FDA approved treatment(s)

Bipolar disorder 1 - maintenance treatment. Epilepsy - by itself or with other meds, for adults & children.

2.2  Popular off-label uses

Initial therapy for bipolar disorder. Bipolar 2 (best treatment, hands down). Treatment-resistant depression / misdiagnosed bipolar 2. SUNCT syndrome headaches.

More about Lamictal approved & off-label uses

3.  When will Lamictal (lamotrigine) start working?

3.1  How long until Lamictal starts working

For epilepsy: However long it takes to get in the neighborhood of 200–400mg a day.

For bipolar: If you’re in a depressed phase Lamictal can work within two-four days of your first 25mg. The average dosage that works for depression is 100mg, and it typically takes 2–4 weeks to reach that dosage.

For mania/true mood stabilization it’s 150–200mg a day. But, like everything else about Lamictal, it depends. This one is a lot harder to nail down, but a month is the closest thing to an average that we have.

3.2  Will Lamictal really work for what I have?

For epilepsy: The odds are decent.
For bipolar 2: Best med on the market.
For bipolar 1: If you take it like the FDA tells you to - after being stable on another med - the chances are pretty good you’ll stay stable.

More about how long until, and how well will Lamictal work; and how Lamictal compares with other drugs

4.  How to take and stop taking Lamictal (lamotrigine)

4.1  How to take Lamictal

Lamictal has the most complicated dosing instructions and schedules¹ to increase the dosage (titration) of any crazy med. They take up 9 pages of the PI sheet. You need to look at the expanded dosing and titration page, as there’s no way to easily explain it.

4.2  How to stop taking Lamictal

According to GSK: “Lamictal should be tapered over a period of at least 2 weeks (approximately 50% reduction per week).” Our rule of thumb: decrease the dosage at the same rate you increased it. Otherwise as slowly as you can. 25–50mg a day every week until you’re down to 100mg a day, then 25mg a day per week. If you have to stop due to a really serious side effect, such as SJS (Stevens-Johnson Syndrome, a.k.a. The Rash or the Lamictal rash), then you and your doctor (or whoever is in the emergency room) will have to figure out a faster schedule.

More about taking and discontinuing Lamictal

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5.  Lamictal’s (lamotrigine’s) pros and cons

5.1  Pros

The best medication on the market to deal with bipolar depression without the risks of mania or lowering the seizure threshold associated with antidepressants. Weight neutral. One of the safest meds to use during pregnancy. The side effects suck less than the other meds with FDA approval for maintenance treatment of bipolar disorder.

5.2  Cons

That “without the risk of mania” is only after you’re taking enough. You might get a little too happy the first couple of weeks. Easily affected by drug-drug interactions, in spite of being metabolized in such a way that only a few meds should affect it. Can mess with your skin in all sorts of ways that could cause you to panic and stop taking it when you don’t have to.

5.3  Interesting stuff your doctor probably didn’t tell you

Women have noticeably more side effects than men. Lamictal prescriptions have been filled with Lamisil. Why GSK gave them such similar names is beyond me.
More of Lamictal pros, cons, and interesting stuff

6.  Lamictal (lamotrigine) side effects

6.1  Typical Lamictal side effects

Rashes, photosensitivity, rashes, lethargy, rashes, insomnia, rashes, memory and cognitive problems, rashes, and headaches that are sometimes really bad. Did I mention rashes and assorted other skin problems? The rash thing is overblown, serious rashes aren’t all that common. Other skin problems, and mildly annoying, short-term rashes happen all the time. The Lamictal headache is usually temporary, and if you do get it, the odds are it will be when you change the dosage. The lethargy, insomnia, and stupids usually diminish and may even go away.

6.2  Uncommon Lamictal side effects

A specific type of insomnia where you’re really sleepy but just can’t fall asleep. Muscle aches, everything from just a twinge in your neck or back to full-body aches that make you wonder if you were possessed by some spirit that made you participate in a triathalon the day before and have no memory of it. Similar to what you get with Topamax. Dry mouth. OCD-like symptoms. Don’t be surprised if you get anxious or have other hypomanic effects if taking it for bipolar disorder.

6.3  Freaky rare Lamictal side effects

Going deaf. Permanently.
Hiccups that won’t stop.
More about Lamictal side effects

7.  What Lamictal (lamotrigine) is best known for

The Rash. Everyone is scared shitless of The Lamictal Rash.
Totally kicking the assess of Symbyax, Seroquel, and whatever other atypical antipsychotics with FDA approval to treat bipolar depression. Despite not having FDA approval to treat bipolar depression.
More about Lamictal black box warnings, noted traits & effects

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8.  Lamictal (lamotrigine) half-life & how long until Lamictal clears your system

Half-life: 25–32 hours, depending on all sorts of factors. And that’s the median average. Clearance: 6–8 days.
Drugs.com’s drug-drug and drug-food interaction checker
More about Lamictal pharmacokinetics & noted drug-drug & drug-food interactions

9.  How Lamictal (lamotrigine) works (the best current guess at any rate).

Originally Lamictal was thought to have one of the simplest mechanism of action of any AED, doing nothing else except inhibiting voltage-sensitive sodium channels and maybe having a little affect on sigma opioid receptors (which are now being studied for all sorts of things). Now it looks like it also inhibits gated sodium and calcium channels, maybe even potassium. It’s still one of the least GABAergic ACs around.
More about how Lamictal works. AKA Lamictal mechanism/method of action, or pharmacodynamics.

10.  Comments

Antiepileptic drugs / anticonvulsants (AEDs / ACs) are generally a pain in the ass to take, and Lamictal is the biggest diva of them all. But Lamictal works, and works well, for two difficult-to-treat conditions: bipolar 2 featuring severe, near-constant depression that is usually misdiagnosed as a variant of unipolar depression, and Lennox-Gastaut syndrome. You may have to drastically alter your lifestyle and that of your entire family (e.g. no more perfume or scented cleaning products) to keep taking it without being covered in a scary-looking, but otherwise benign rash, but that sucks so much less than treatment-resistant bipolar 2 or watching your kid with Lennox-Gastaut hit the floor for the twentieth time today.
More comments As if I didn’t go on long enough here.
Consumer/patient comments about & experiences with Lamictal

11.  Discussion board, PI sheet and other allegedly useful links

Crazy Meds’ Lamictal discussion board
Lamictal’s Full US Prescribing Information / PI Sheet
Allegedly Useful Links. Mostly any official sites we could find for this med and PI sheets from countries other than the US.

Lamictal Index | Brand and Generic Availability ›
Crazy Meds Comprehensive Lamictal pages

Bibliography

¹ That's right, schedules, as in more than one. While many crazy meds have different titration schedules based on what condition you have, and can be influenced by any other medications you may be taking, Lamictal is such a freaking diva about drug-drug interactions that GSK has three different starter packs. But that still doesn't cover things like if you're planning to switch from your existing meds to Lamictal alone, or will you be staying on them.

Date created 31 Dec 1969 - 17:00 Page Author: Jerod Last edited by: JerodPoore

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Lamictal Basic Overview by Jerod is copyright 1969 Jerod

Page design and explanatory material by Jerod Poore, copyright © 2004 - 2012. All rights reserved.

Almost all of the material on this site is by Jerod Poore and is copyright © 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, and 2012 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and the following disclaimer, I’m usually cool with it.

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Very little information about visitors to this site is collected or saved. From time to time I look at search terms used and which pages they bring up in an effort to make the information I present more relevant. And the country of origin, just because I’m geeky like that. That’s about it. Depending on how you feel about Schrodinger, our privacy policy should either assuage or exacerbate your paranoia.
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Crazy Meds is optimized for the browser you’re not using on the platform you wish you had. Between you and me, it all looks a lot cleaner using Firefox or Safari, which is what a plurality of visitors use. And I’m running Windows XP3. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazy Meds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazy Meds is not responsible for whatever weird shit your browser does or does not do when you read this site².
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¹ While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

² Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[begin rant] I rent a dedicated server for Crazy Meds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had the forerunner to QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]