how long until Lamictal starts to work, likelihood Lamictal will work for your condition, and Lamictal vs. other AntiepilepticDrugs/Anticonvulsants

> How Long Until Lamictal Works

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Approved & Off-label Uses | Lamictal Index | How to Take and Discontinue
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Comparatively Effective

Two of the most important things to know when deciding on which med is the best for a particular condition1: how likely is it to work and how long will it take.

The odds of a med working for a particular condition and how long it generally takes to work should be fairly easy to nail down, and not need to be summed up by the Internet shorthand YMMV (Your Mileage May Vary). Aside from it being hard enough to get an accurate diagnosis when brain cooties are involved, why is it so difficult to figure out if Lamictal (lamotrigine) is right for you and how long it will take for you to know that?

  • Because no one is quite sure exactly what causes various conditions.
  • Which is further complicated when everything is a spectrum disorder (e.g. bipolar 1, bipolar 2, all the others they still ignored in DSM-5).
  • And they’re never really sure about how Lamictal works in the first place.
  • Plus, if you have more than one condition for which you’re taking one or more medications to treat, things get really complicated.
  • None of which is helped by studies that produce contradictory results and other quirks in The Literature.

Always remember: if your symptoms suddenly get a lot worse, call your doctor immediately. Any drug that makes your symptoms worse is a drug you probably need to stop taking as soon as possible.

We reference a shitload of studies here, so you might want to see our pages on how to deal if a study is legitimate and the tests and methodologies researchers use to measure the efficacy of medications, including during clinical trials to get FDA approval.

How Long Until Lamictal (lamotrigine) 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 a few days at 25mg, although the average dosage that works for depression is 100mg. That takes anywhere around four to five weeks. For mania/true mood stabilization it’s 150–200mg a day, and that usually happens in six to eight weeks.

How Effective Lamictal (lamotrigine) is for its Approved Uses

For epilepsy: Decent. Lamictal is especially good for two forms of epilepsy - Lennox-Gastaut syndrome (for which it’s approved) and autosomal dominant nocturnal frontal lobe epilepsy, which is too unusual to be worth getting official approval for.
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.

Likelihood Lamictal (lamotrigine) will Work for Off-Label Applications

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Lamictal (lamotrigine) versus Other AntiepilepticDrugs/Anticonvulsants for its Approved Indications


Carbamazepine is better than lamotrigine for time to first seizure, but this efficacy outcome might be dependent on initial dosing and could indicate that initial lamotrigine dosing in the trial was conservative, which would favour better tolerability outcomes, but detract from its efficacy early in the study. This inference is supported by the way in which per-protocol analysis of time to 12-month remission shows lamotrigine catching up with and eventually overtaking carbamazepine. There is also a lower rate of rash in patients randomised to lamotrigine in this arm of the study than might have been expected, a further potential consequence of conservative initial dosing. The SANAD study of effectiveness of carbamazepine, gabapentin, lamotrigine, oxcarbazepine, or topiramate for treatment of partial epilepsy: an unblinded randomised controlled trial

  • Lamictal vs. Topamax in people with partial epilepsy who are already taking Tegretol or Dilantin (phenytoin). Which med used as an add-on will have the greater adverse effect on cognitive performance? Any guesses? That’s right, Topamax makes you teh dum.
    • Lamictal vs. Topamax in AED polytherapy. In a study done previously to the one above, the cognitive performance tests were given to people who were taking Topamax or Lamictal as part of an AED cocktail. They found that Topamax is more likely than Lamictal to give you the stoopids. This is one of the few studies where cognitive side effects and dosage aren’t necessarily related, which is something we see a lot of.
  • AED geezer cagematch! Tegretol vs. clobazam vs. Neurontin vs. Keppra vs. Lamictal vs. Trileptal vs. Dilantin (phenytoin) vs. Topamax vs. Depakote vs. Zonegran in people 55 or older with a variety of types of epilepsy. The winner: Lamictal, with 79% of people staying on it for one year or longer and 54% seizure-free. Keppra was a close second with 73% staying on it and 43% seizure-free. The same was true even for refractory epilepsy, with 47.4% responding to Lamictal and 38.9% responding to Keppra. The biggest loser: Trileptal, with only 24% staying on and 4% remaining seizure-free.
  • Keppra vs. Tegretol vs. Lamictal. This study investigated the risk factors of cardiovascular disease in patients with epilepsy who take different AEDs. The results: Uh, well, Tegretol kind of made things a little worse, especially with women, who gained weight on it and Lamictal due to inactivity. Tegretol also raised total cholesterol (TC), low-density lipoprotein (LDL) and high-density lipoprotein in both men and women.
  • Keppra vs. Lamictal vs. phenobarbital in people with Alzheimer’s. You know someone is old if they’re taking pheno for epilepsy. The results: a tie! At least when it comes to seizures. Lamictal made them feel better and Keppra helped with the Alzheimer’s symptoms a little, neither of which is surprising.
  • Keppra vs. Lamictal - which one gets you more pissed off? Finally, a useful study! The results: a tie. Both in control of partial seizures and improvement of mood and lessening hostility, Keppra works as well as Lamictal.
  • AED stupidity cagematch! Depakote vs. Dilantin (phenytoin) vs. Keppra vs. Lamictal vs. Neurontin vs. Tegretol vs. Topamax vs. Trileptal vs. Zonegran in which makes you the stoopidedist. The wiener: Stupamax Dopamax Topamax, with 21.5% of people reporting intolerable (where they had to stop taking it) cognitive side effects. In second place was Zonegran with 14.9% and in third place was Trileptal with 11.6%. Keppra scored fairly high with 10.4%, but that includes people who were taking Keppra along with one or more other AEDs. When taking only Keppra it had the fewest (no number in the abstract) number of reported cognitive side effects.

How Lamictal (lamotrigine) Compares with Other Drugs for Off-Label Treatments

Migraines and other headaches

  • Low-dosage Topamax vs. Lamictal vs. placebo for migraine prophylaxis. Lamictal? For migraines? Actually Lamictal is used off-label all the time for headaches, proving the adage2 that whatever adverse event (side effect) an AED causes it can also treat, and vice versa. Or the other way around. In any event the results: Topamax wins, probably because Lamictal usually needs a higher dosage and is most effective for migraine with aura.

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Approved & Off-label Uses | Lamictal Index | How to Take and Discontinue

1 Assuming you were correctly diagnosed in the first place.

2 If you can call something I made up an adage.

If you have any questions not answered here, please see the Crazymeds Lamictal discussion board. We welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why we write these damn things. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds. — Jerod Poore, CME, Publisher Crazymeds (

Last modified on Sunday, 23 February, 2014 at 23:22:09 by JerodPoorePage Author Date created
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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 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.

3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion as anonymity on teh Intergoogles. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.

* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.

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