Highlighting uses, dosage, how to take & discontinue, side effects, pros & cons, and more

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Brand & Generic Names; Drug Classes

US brand name: Lamictal
Generic name: lamotrigine

Drug Class(es)

Primary drug class: Antidepressants
Additional drug class(es): MoodStabilizers (approved) Antidepressants (off-label) Migraine/NeuropathicPain (off-label)

Approved & Off-Label Uses (Indications)

Lamictal’s US FDA Approved Treatment(s)

Bipolar 1 - maintenance treatment. Epilepsy - by itself or with other meds as maintenance, for adults & children. Unlike most other meds Lamictal is not approved as initial therapy (a med you take to get your symptoms under control), but to switch to after something else gets your symptoms under control because Lamictal tends to suck less.

Uses Approved Overseas but not in the US

Off-Label Uses of Lamictal

Initial therapy for bipolar disorder. Bipolar 2 (best treatment, hands down - or maybe not). Treatment-resistant depression / misdiagnosed bipolar 2. SUNCT syndrome headaches.

When & If Lamictal Will Work

Lamictal’s Usual Onset of Action (when it starts working)

If you’re using Lamictal as directed it should work immediately, as you would transition from a working to Lamictal and, in theory, never lose control over your symptoms. If you’re using it off-label as initial therapy or replacing something that doesn’t work …

Epilepsy

Usually whenever you reach a dosage of 200–400mg a day.

Bipolar

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

For mania/true mood stabilization it depends the average therapeutic dosage is around 150–200mg a day. But, like everything else, it depends. This one is a lot harder to nail down, but a month is the closest thing to an average that we have. Return to Table of Contents

Likelihood of Working

Epilepsy

The odds are decent that it will work for epilepsy, especially if you follow the PI sheet and add it to, or convert from another AED.

Bipolar 2

Generally considered to be the best drug on the market for bipolar 2. While there are always conflicting data, your mileage may vary, yadda yadda yadda, with its track record for efficacy and other factors, Lamictal should be the first med considered, but not necessarily the first med used, by many, if not most people diagnosed with bipolar 2.

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. If you start it while manic1 or only mild-to-moderately depressed and aren’t taking, let alone stable, on another med, expect to be bouncing off the ceiling and have your cycling sped up.

Return to Table of Contents

Taking and Discontinuing

How to Take Lamictal

Lamictal has the most complicated dosing instructions and schedules2 to increase the dosage (titration) of any crazy med. They take up 9 pages of the PI sheet. So here it is, which works for both epilepsy and bipolar disorder:

  1. Find a med that works.
  2. Once your symptoms are under control, decide if the side effects suck so much you want to be on a different med.
  3. If they do, switch to Lamictal by taking the two meds at the same time, lowering the dosage of the med you don’t like while increasing the dosage of Lamictal per the instructions in the appropriate Lamictal starter pack.

That’s essentially it. If you really want Lamictal to work, do it the way it’s approved to and follow GSK’s instructions. This is one of the few times I recommend a target dosage. The average target dosage for adults with bipolar disorder is 200 mg a day, taken as 100 mg twice daily. If you had your symptoms under control at a fairly low dosage of another med, then you can probably get away with a similarly low dosage of Lamictal. Work it out with your doctor.

Return to Table of Contents

How to Stop Taking Lamictal (discontinuation / withdrawal)

Manufacturer’s Recommendations

Glaxo-Smith Kline (GSK) has a “discontinuation strategy” of sorts:

If a decision is made to discontinue therapy, a step-wise reduction of dose over at least 2 weeks (approximately 50% per week) is recommended unless safety concerns require a more rapid withdrawal. --the Full US Lamictal PI sheet

Crazymeds’ Suggestions

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), then you and your doctor (or whoever is in the emergency room) will have to figure out a faster schedule. Although if you’re in the ER with with SJS it’ll probably be extremely simple: you stop taking it immediately and take Benadryl (diphenhydramine) - or something similar - for the rash and one or more of clonazepam, some other benzodiazepine, and more of any other antiepileptic drug(s) you’re already taking. Return to Table of Contents

Lamictal’s Pros and Cons

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.
  • Just the best med on the market for bipolar depression.
  • 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.

Return to Table of Contents

Cons

  • That “without the risk of mania” is only after you’re taking enough, usually 200mg a day. You might get a little too happy the first couple of weeks. Or too irritable, anxious and otherwise unpleasant to be around.
  • 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.
  • Which is really a shame, because Lamictal is one of those drugs where if you stop taking it then try it again later it may or may not work as well the next time.

Return to Table of Contents

Interesting Stuff your Doctor Probably didn’t Tell You about Lamictal

  • Women have noticeably more side effects than men.
  • Lamictal prescriptions have been filled with Lamisil, and vice versa.
    • Why GSK gave them both such similar names is beyond me.
    • Bonus irony: Given all the dermatological problems Lamictal causes, it’s possible someone would need prescriptions for both Lamictal and Lamisil.
  • Lamictal was originally developed as a folate antagonist, like how many antimalarial drugs work, except targeting your brain. It was supposed to be a side effect in a pill to test if folate had anything to do with seizures.
  • There’s a genetic test for susceptibility to The Rash
    • At least if you’re of East Asian descent (excluding Japanese and Korean3)
    • But if your genetic heritage is from elsewhere in East, Southeast, and South Asia, talk to your doctor about getting screened for the HLA-B*1502 allele before starting Lamictal, Tegretol, and other meds, crazy or not, where SJS and toxic epidermal necrolysis (TEN) are actual concerns.

Return to Table of Contents

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.
  • A multiday hangover if you drink half a lite beer.

Return to Table of Contents




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Lamictal’s Potential Side Effects

Potential Side Effects All Crazy Meds Have

No matter which neurological and/or psychiatric drug you take, you’ll probably get one or more of these side effects. These will usually be gone, or at least will diminish to the point where you barely notice it most of the time, within a week or two.

  • Headache
  • Drowsiness / fatigue - even when taking stimulants in some circumstances.
  • Insomnia, instead of or alternating with the drowsiness.
  • Nausea
  • Assorted other minor GI complaints (constipation, diarrhea, etc.)
  • Generally feeling spacey / out of it
    • Which can all add up to the ever-helpful “flu-like symptoms” listed as an adverse event on the PI sheet of practically every medication on the planet used to treat almost any condition humans and other animals could have.4
  • All crazy meds can, and probably will affect your dreams as well. There is no way of telling if that will be good or bad, let alone if this side effect is permanent or temporary.
  • Any of the above side effects you see listed again below means they’re even more likely to happen and/or stick around longer and/or are worse than most other meds.

Typical Potential Side Effects

Rash, insomnia, itchy skin, lethargy, photosensitivity, 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, as serious rashes aren’t all that common. Other skin problems, and mildly annoying, short-term rashes happen all the time. The headache is usually temporary, and if you do get it, the odds are it will be when you change the dosage. The lethargy and stupids usually diminish and may even go away, especially if you take folic acid. Folic acid may even help with some of the skin problems. The insomnia is one of those side effects you’ll know is temporary as soon as is stops and doesn’t come back for a few months.

Return to Table of Contents

Uncommon Potential 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.

As with the regular type of insomnia mentioned above, the muscle aches are one of those side effects you’ll know is temporary when it stops and doesn’t return. The dead-tired-but-still-can’t-sleep insomnia is like the headache - it might go away and only return when you change dosage, or it might go away for good (more or less) after some indeterminate amount of time, or it might just come and go on its own schedule5 for as long as you’re taking it.

Return to Table of Contents

Freaky Rare Side Effects

Going deaf. Permanently.
Hiccups that won’t stop.

Return to Table of Contents


What You Really Need to be Careful About

Stevens-Johnson Syndrome. AKA The Rash.

Return to Table of Contents

Pregnancy Category

Return to Table of Contents

Pharmacology

Lamictal’s Half-Life & How Long Until It Clears Your System

Half-life: 25–32 hours , depending on all sorts of factors. And that’s the median average. Plasma Clearance: 6–8 days.

Steady State

Steady state reached in 14–28 days

Half-life is the average time it takes for you to process half of the drug’s active ingredient. If a drug has a half-life of around 24 hours and you take a dose of 100mg, you’ll have roughly the equivalent a 50mg dose after one day, a 25mg dose after two days, and so on. The rule of thumb is: multiply the half-life by five and you get how long it is for the dose you took to be cleared from your bloodstream6, so there’s nothing swimming around to attach itself to your brain and start doing stuff. That’s called “plasma clearance.” Complete clearance is a complex equation based on a lot of factors which may or may not: be published in the PI sheet, include personal data like your weight, or even completely figured out by corporate and independent researchers. It usually winds up being 2–5 days after plasma clearance no matter what7, but can take weeks. Sometimes a drug will clear from your brain and other organs before it clears from your blood.

Steady state is the flipside of half-life. This is when you can expect to get over side effects caused by fluctuating amounts of a medication in your bloodstream. Often, but not always the same amount of time as the plasma clearance above.

Return to Table of Contents

How lamotrigine Works

the current best guess at any rate
Originally designed as a folate antagonist (like antimalarial drugs), it 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 AEDs around.

Return to Table of Contents

Active Ingredient

freebase lamotrigine USP


The active ingredient is usually the same as the generic name, but more often than not it’s a chemical salt of the substance identified as the generic. E.g. Fluoxetine is the generic for Prozac, but the active ingredient is fluoxetine hydrochloride (or HCl). It usually doesn’t make much of a difference outside of the more esoteric aspects of a drug’s pharmacology, but not always.

Return to Table of Contents

Shelf Life

2mg chewable & ODTs: 2 years. Tablets and other chewable & ODTs: 3 years. Return to Table of Contents

Lamictal’s Noted Drug-Drug, Drug-Food & Drug-Supplement Interactions

  • Rooibos (Aspalathus linearis)/ red tea may be a potent inducer of UGTs. As such you should probably avoid Rooibos/red tea/whatever it’s called where you live if you’re taking Lamictal.
  • Like many crazy meds, especially AEDs, you may need to take more Lamictal and/or take it more often if you smoke.
  • I cannot stress often enough the interaction between Lamictal and anything containing ethinyl estradiol, which is practically every form of pharmacological birth control except the Depo-Provera (medroxyprogesterone) injection.
  • Lamictal’s bioavailability may be affected by food. That’s the only study I’ve found showing any affect food has had on Lamictal, but this med is so screwy it wouldn’t surprise me if it can make enough of a difference for some people.
  • Like most AEDs, Lamictal messes with how your body deals with folate. So you’ll probably need to take a folic acid supplement.
  • Your doctor and pharmacist should have at least mentioned Lamictal’s interactions with Tegretol/Equetro (carbamazepine) and the valproates: Depakote, valproic acid, Stavzor, and commie Depakote sodium valproate / valproate sodium. There are even more interactions involved. So, if you have multiple brain cooties or your doctor hasn’t quite pinned down what the hell is wrong with you:
    • Lamictal + carbamazapine could be a bad idea.
    • Lamictal + Trileptal (oxcarbazepine) could be an even worse idea.
    • While Lamictal + Depakote can be a really good idea if either med by itself isn’t working well enough to control your seizures.
    • And Lamictal + Topamax can be a good idea, but only if you take around the same amount of each and you aren’t taking high dosages of either.
  • What’s the deal with the above? It’s in how the meds work, specifically with sodium channels. Too much and you don’t just get stupid, you may as well not be taking an AED. But if the drugs compliment each other, then your brain will be a lot happier.
  • Lamictal is notorious for causing multiday hangovers if you drink the least amount of alcohol.
    • Drinking while taking AEDs isn’t that great an idea, but unless you enjoy waking up with an epic hangover, don’t even drink half a lite beer if you’re taking Lamictal.

Return to Table of Contents

Check for Other Drug-Drug, Drug-Food & Drug-Supplement Interactions Lamictal may have at

Drugs.com’s drug-drug and drug-food interaction checker

It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on teh Faecesbooks.
Learn more about drug-everything interactions on our page of tips about taking crazy meds.



Name, Address, Serial Number (Generic and Overseas Availability)

Available in the US as a generic? Yes

Other Trade Names and Overseas Availability

Not including controlled/extended/sustained release suffixes (Efexor ER, Trevilor retard e.g.) or branded generics that are a hyphenate of the generic name and the drug company name (Apo-Citalopram e.g.).

Available as Lamictal in These Countries

  • Australia
  • Canada
  • EU
  • Ireland
  • Israel
  • Japan
  • Lebanon
  • New Zealand
  • Russia
  • UK

Available as Generic Lamotrigine in These Countries

  • Australia
  • Canada
  • Egypt
  • EU
  • Ireland
  • Israel
  • New Zealand
  • Peru
  • South Africa
  • UK
  • Yemen

Transliterated, Overseas Trade and Branded Generic Names

  • Amitral: Algeria
  • Crisomet: Spain
  • Labileno: Spain
  • Loxol: Iraq, Jordon, Saudi Arabia
  • لاميكتال: Algeria, Egypt, Saudi Arabia - “Lamictal” transliterated into Arabic
  • لامكتال: Jordon
  • أميترال: Algeria
  • لوكسول: Saudi Arabia
  • 라믹탈: Korea
  • Ламиктал: Russia - “Lamictal” transliterated into Cyrillic
  • למיקטל: Israel - “Lamictal” transliterated into Hebrew
  • Lamictin: South Africa
  • Lamitor: South Africa
  • lamotrigin: Austria, Czech Republic, Denmark, Finland, Germany, Norway, Sweden, Switzerland
  • lamótrigín: Iceland
  • lamotrigina: Argentina, Brazil, Chile, Italy, Mexico, Peru, Portugal, Spain, and probably everywhere else they speak Italian, Portuguese, or Spanish
  • Lamotrine: Egypt, Yemen
  • למוג’ין: Israel - “lamotrigine” transliterated into Hebrew

Return to Table of Contents

Shapes & Sizes (How Supplied)

  • Difficult-to-swallow, shield-shaped, immediate-release Lamictal:
    • 25 mg tablets
    • 100 mg tablets
    • 150 mg tablets
    • 200 mg tablets
    • Generic lamotrigine comes in various shapes (see pictures below)
  • Lamictal ODT:
    • 25 mg orally disintegrating tablets
    • 50 mg orally disintegrating tablets
    • 100 mg orally disintegrating tablets
    • 200 mg orally disintegrating tablets
  • Lamictal Chewable:
    • 2 mg chewable dispersible tablets
    • 5 mg chewable dispersible tablets
    • 25 mg chewable dispersible tablets
  • Lamictal-XR (round with a white center):
    • 25 mg extended-release tablets
    • 100 mg extended-release tablets
    • 150 mg extended-release tablets
    • 200 mg extended-release tablets
    • 300 mg extended-release tablets
Lamictal and lamotrigine 25 mg tablets
Left: Brand Lamictal 25 mg Tablets. Right: Teva Generic Lamotrigine 25 mg Tablets.
Generic lamotrigine 100 mg tablets
Left: Teva Generic Lamotrigine 100 mg Tablets. Center: Taro Generic Lamotrigine 100 mg Tablets. Right: Dr. Reddy Generic Lamotrigine 100 mg Tablets.

Lamictal also comes in liquid capsules, but those aren’t available in the US.

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Comments, PI Sheet, Ratings, Reviews and More

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 it 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.

Crazy meds are an exercise in patience. You need to wait for side effects to go away. You need to wait for the meds to start working. In The Prescriber’s Guide (Essential Psychopharmacology Series) Stahl has “Wait. Wait. Wait.” as the first three things to try in order to deal with side effects that he must of had a keyboard macro for it. Lamictal, being Lamictal, has to be the most extreme when it comes to that by requiring you to have your symptoms under control by another medication before starting. At least if you want to have the best chance for Lamictal to work. The idea is for Lamictal to replace whatever you’re taking.

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. See the extended comments and detailed side effects pages for more information on Lamictal’s interaction with fragrances.

In spite of the climate of fear that permeates everything having to do with it because of The Rash, and loud complaints about killer headaches and full-body muscle aches, Lamictal actually has one of the lowest side effect profiles around. It’s not as low as Keppra’s but it is almost as low as Neurontin’s, with the added advantage of actually doing something for bipolar disorder and forms of epilepsy that are usually way too severe for Neurontin to handle. It may be the pickiest of all AEDs, but has been an absolute lifesaver for thousands of people.


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Pages and Forum Topics Google Thinks are Relevant to Your Mental Health

Full US PI sheet, Global SPCs & PILs, Other Consumer Review & Rating Sites, and Other Sites that may be of Interest

Lamictal’s Full US Prescribing Information / PI Sheet

Official Sites

PI Sheets for Other Forms

PI Sheets from Around the World

Rating & Review Sites

Other Sites of Interest

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Discussion board

If you have any questions not answered here, please see the Crazymeds Lamictal discussion board. Return to Table of Contents


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References

  1. the Full US Lamictal PI sheet
  2. Faught, Edward. “Topiramate in the treatment of partial and generalized epilepsy.” Neuropsychiatric disease and treatment 3.6 (2007): 811-821.
  3. Stahl, Stephen M. Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications (Essential Psychopharmacology Series) Third edition Cambridge University Press 2008. ISBN:978–0521673761
  4. Julien, Robert M. Ph.D, Claire D. Advokat, and Joseph Comaty Primer of Drug Action: A comprehensive guide to the actions, uses, and side effects of psychoactive drugs 12th edition Worth Publishers 2011. ISBN:978–1429233439
  5. Stahl, Stephen M. The Prescriber’s Guide (Essential Psychopharmacology Series) Third edition Cambridge University Press 2009. ISBN:978–0521743990
  6. Virani, Adil S., K. Bezchlibnyk-Butler, and J. Jeffries Clinical Handbook of Psychotropic Drugs 18th edition Hogrefe & Huber Publishers 2009. ISBN:978–0889373693
  7. Silberstein, Stephen D., Michael J. Marmura Essential Neuropharmacology: The Prescriber’s Guide Cambridge University Press 2010. ISBN:978–0521136723
  8. Stein, Dan, Bernard Lerer, Stephen Stahl Evidence-based Psychopharmacology Cambridge University Press 2005. ISBN:978–0521531887
  9. Kaufman, David Myland, MD Clinical Neurology for Psychiatrists W.B. Saunders Company 2001 ISBN:1416030743
  10. Levy, René H., Richard H. Mattson, Brian S. Meldrum, and Emilio PeruccaAntiepileptic Drugs Lippincott Williams & Wilkins 2003. ISBN:0781723213
  11. Mosby’s Drug Consult 2007 (Generic Prescription Physician’s Reference Book Series) © 2007 ISBN:978-0323040587 An imprint of Elsevier.
  12. PDR: Physicians’ Desk Reference 2010 64th edition
  13. Marson, Anthony G., Asya M. Al-Kharusi, Muna Alwaidh, Richard Appleton, Gus A. Baker, David W. Chadwick, Celia Cramp et al. “The SANAD study of effectiveness of carbamazepine, gabapentin, lamotrigine, oxcarbazepine, or topiramate for treatment of partial epilepsy: an unblinded randomised controlled trial.” The Lancet 369, no. 9566 (2007): 1000-1015.
  14. Marson, Anthony G., Asya M. Al-Kharusi, Muna Alwaidh, Richard Appleton, Gus A. Baker, David W. Chadwick, Celia Cramp et al. “The SANAD study of effectiveness of valproate, lamotrigine, or topiramate for generalised and unclassifiable epilepsy: an unblinded randomised controlled trial.” The Lancet 369, no. 9566 (2007): 1016-1026.
  15. Arif, Hiba, Richard Buchsbaum, Joanna Pierro, Michael Whalen, Jessica Sims, Stanley R. Resor, Carl W. Bazil, and Lawrence J. Hirsch. “Comparative effectiveness of 10 antiepileptic drugs in older adults with epilepsy.” Archives of neurology 67, no. 4 (2010): 408-415.
  16. Fuller, Matthew A. “Medical Management of Bipolar Disorder: A Pharmacologic Perspective.” ANNALS OF CLINICAL PSYCHIATRY (2011): 23-48.
  17. “Lamictal (lamotrigine) and Lamisil (terbinafine hydrochloride) ‘Dear Healthcare Professional Letter.’” U.S. Food and Drug Administration website. 2000 Last Updated: 08/03/2009. Last Accessed: 17 July 2014.
  18. Hikma Pharmaceuticals Central Nervous System Portfolio Last Accessed 04 July 2014
  19. ChemSpider’s lamotrigine page Last Accessed 04 July 2014
  20. New Zealand Medicines and Medical Devices Safety Authority Medicine Data Sheet for Lamictal Dispersible/Chewable Tablets Last Accessed 04 July 2014
  21. electronic Medicines Compendium Summary of Product Characteristics for Lamictal Tablets SPC Last updated 08 April 2014. Last Accessed 04 July 2014

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1 How many of us voluntarily see a doctor for the first time - or the first time after several years - during a euphoric mania? The only reason I did was because that was when I could deal with the agoraphobia and new people. I must be one of very few of the bipolar who consistently see new doctors while manic to some degree.

2 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, it 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.

3 You can still discuss HLA-B*1502 allele screening with your doctor if you're Japanese, Korean, Kazakh, or even Caucasian, but as far less than 1% of those populations have it, you'd probably be wasting time and money. SJS and TEN can still happen for all sorts of reasons we've yet to determine, some people are just lucky enough to have one we know about.

4 As well as being an indication of half of said conditions.

5 There are probably all sorts of factors involved, such as life stressors or a random-seeming interaction with caffeine like Topamax has. Then again, it's Lamictal, and if there is any drug on the planet that is more random I'm glad I'm not taking it.

6 Based on Julien's calculations from A Primer of Drug Action, the half-life multiplied by five is the generally accepted estimate of how long it takes a single dose of any given drug to be eliminated from the blood stream/plasma of someone with a normal metabolism. That's also the rough estimate for steady state if they can't get, or won't provide a number for that.

7 For crazy meds. I have no idea what the average complete clearance is for other types of medications. For all I know there are drugs that utterly vanish from your system in under five passes, and others that won't let go of your squishy bits for years after you stop taking them.

8 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!


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 (crazymeds.us)


Last modified on Wednesday, 04 May, 2016 at 17:22:00 by JerodPoorePage Author Date created January 18, 2011, at 15:16:23
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Citation options to copy & paste into your article:
Plain text:Poore, Jerod. “Lamictal (lamotrigine): a Review for the Educated Consumer.” Crazymeds (crazymeds.us). (2011).
with Microdata: <span itemprop='citation'>Poore, Jerod. "Lamictal (lamotrigine)." <em>Crazymeds (crazymeds.us)</em>.(2011).</span>
Linked:<a href="http://scholar.google.com/citations?user=5rkux7sAAAAJ&hl=en&oi=sra">Poore, Jerod</a>. <a href='https://www.crazymeds.us/pmwiki/pmwiki.php/Meds/Lamictal'>"Lamictal (lamotrigine): a Review for the Educated Consumer."</a>. <a href="https://www.crazymeds.us/pmwiki/pmwiki.php/Main/HomePage"> <em>Crazymeds (crazymeds.us)</em></a>. (2011).
with Microdata:<span itemprop='citation'> <a href="http://scholar.google.com/citations?user=5rkux7sAAAAJ&hl=en&oi=sra">Poore, Jerod</a>. <a href='https://www.crazymeds.us/pmwiki/pmwiki.php/Meds/Lamictal'>"Lamictal (lamotrigine): a Review for the Educated Consumer."</a>. <a href="https://www.crazymeds.us/pmwiki/pmwiki.php/Main/HomePage"> <em>Crazymeds (crazymeds.us)</em></a>. (2011).</span>

Lamictal, and all other drug names on this page and used throughout the site, are a trademark of someone else. Lamictal’s PI Sheet will probably have the name of the manufacturer and trademark owner (they’re not always the same company) at or near the very bottom. Or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing. It may of changed hands by the time you finished reading this article.




Page design and explanatory material by Jerod Poore, copyright © 2003 - 2016. All rights reserved.
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Almost all of the material on this site is by Jerod Poore and is copyright © 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, and 2016 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 something along the lines of following disclaimer, I’m usually cool with it.



All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot.
Know your sources!
Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained from the medications’ product information / summary of product characteristic (PI/SPC) sheets and/or medication guides - which is all you get from sites like WebMD, RxList, NAMBLA NAMI, etc., the sources that are referenced throughout the site, our personal experience and the experiences family, friends, and what people have reported on various reputable sites all over teh intergoogles. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or medication guide/patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
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.
Crazymeds is optimized for ridiculously large screens and browsers that don’t block ads. I use Firefox and Chrome, running under Windows 72. 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, Crazymeds 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 Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
Crazymeds now uses a secure server, but it is not so secure that you can discuss anything having to do with nuclear power facilities, air traffic control systems, aircraft navigation systems, weapons control systems, or any other system requiring failsafe operation whose failure could lead to injury, death or environmental damage. Just so you know. So if you’re mentally interesting and have a job that deals with that sort of thing, talk about said job elsewhere. Otherwise feel free to discuss your meds and brain cooties.
No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. Use only as directed. Void where prohibited. Contains nuts. Certain restrictions may apply. All data are subject to availability. Not available on all mobile devices, in the 12 Galaxies Guiltied to a Zegnatronic Rocket Society, or in all dimensions of reality. Hail Xenu!

‘Everything is true, nothing is permitted.’ - Jerod Poore


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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