from the common to the rare; how long they last & how to deal with them

> Lamictal Side Effects



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Pros & Cons, Interesting Stuff Your Doctor Didn’t Tell You | Lamictal Index | Blackbox Warning & Noted Traits
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About Side Effects

Potential side effects (adverse events in fancy pharmaceutical talk) are often used as a rationalization to not take Lamictal (lamotrigine). Many people will stop taking an otherwise working drug because of one or more side effects that are relatively minor and/or often temporary. There may even be ways to counter or mitigate the problematic effects.

It all comes down to a very simple equation: which sucks less?

There is no perfect drug. If you keep switching meds in the hopes of finding something with no side effect, or irrelevant side effects that don’t bug you as much, you could wind up treatment-resistant, and a med that worked before may work not as well as it did the first time, if at all.

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.
  • 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.

So don’t operate any heavy machinery and try to avoid driving the first couple of days. We always recommend1 starting a new med Friday night / Saturday morning (or whenever your day off is) so you have an idea of how it will affect you for the first week or two. Keep in mind: most side effects are usually temporary in nature.




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Lamictal (lamotrigine) Typical Side Effects

Most everyone gets at least one or two of these
In case you missed it on the previous page: women taking Lamictal (lamotrigine) are more likely to be affected by side effects than men.
  • Rashes
  • Insomnia
  • Itchy skin
  • Lethargy
  • Photosensitivity
  • Memory and cognitive problems
  • Contact dermatitis
  • Headaches that are sometimes really bad
  • Did I mention rashes and assorted other skin problems? Actually the rash thing is blown way out of proportion. Lamictal does tend to exacerbate any existing dermatological problems you already have and/or might make you susceptible to ones you didn’t have before. Such as:
    • Fungal infections like athlete’s foot/ring worm/jock itch2
    • Dry, itchy skin
    • Acne
    • Poison oak & poison ivy may bother you more - and it can really suck if you wind up reacting to them after touching a pet when you previously never knew there was any poison oak or ivy in the area

But serious, life-threatening rashes aren’t really common.

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 in severity and may even go away. Because Lamictal is a folate antagonist3 you should talk to your doctor about taking 400–1,000mcg of folic acid a day. That will probably help with the lethargy and might help with the stupids.
If you get stupid, Do.Not.Panic. The stupids tend to be dose-dependent. No need to throw the whole bottle in the toilet4, as not taking one 25mg tablet will probably make you smart again. Assuming you were smart before Lamictal5. (You do know to get your psychiatrist’s/neurologist’s/prescriber’s okay before changing your dosage, don’t you? I thought so.)

Lamictal (lamotrigine) Uncommon Side Effects

You may or may not get one or more of these, so don’t be surprised either way
  • A specific type of insomnia where you’re really sleepy but just can’t fall asleep. It’s different from not being able to sleep due to racing thoughts and other symptoms of hypomania6.
  • But don’t be surprised if do get symptoms of hypomania, even if you’re not bipolar.
  • 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.7
  • Dry mouth
  • OCD-like symptoms
  • Hair thinning / loss

Potentially Dangerous Side Effects of Lamictal (lamotrigine)

If you have one or more of these, call your doctor ASAP. Or now. Or get the hell off of the Internet and go to the ER NOW!

Here is how you determine if a Lamictal-caused rash is dangerous:

  • If you have a rash that itches AND a fever you need to call and talk to your doctor immediately.
  • If you have an itchy rash AND you can see it spreading OR your fever is above 100F/38C you need to see your doctor right now. If your doctor isn’t available you need to get to an emergency room right now.
  • If you have a rash that doesn’t meet the above criteria (it itches but you don’t have a fever, or you have a bit of a fever but the rash doesn’t itch) you need to discuss it with your doctor as soon as possible. As we, GSK, and everyone else with a clude repeatedly tell you

Although benign rashes are also caused by LAMICTAL, it is not possible to predict reliably which rashes will prove to be serious or life threatening. Accordingly, LAMICTAL should ordinarily be discontinued at the first sign of rash, unless the rash is clearly not drug related. Discontinuation of treatment may not prevent a rash from becoming life threatening or permanently disabling or disfiguring. --Lamictal US PI sheet

While the majority of rashes and other dermatological problems caused by Lamictal are benign, albeit annoying, actual Stevens-Johnson Syndrome (SJS) - better known as The Rash or the Lamictal rash - and toxic epidermal necrolysis (TEN) are potentially life threatening.

There’s more detail about The Lamictal Rash on the black box and other warnings page.

Lamictal Freaky Rare Side Effects

You won’t get these. Unless you already have and that’s why you’re here

Now that is a recipe for the weirdest phone sex service ever.

For all known side effects, see the Lamictal (lamotrigine) full US prescribing information. Or really indulge your paranoia by reading every PI sheet in the world we can find.

Be very careful. Reading the PI sheet for a drug you haven’t been prescribed, or even discussed with your doctor, can often be an exercise in the fear of medications (pharmacophobia).


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Ways to Counter/Minimize/Deal with Some Side Effects of Lamictal (lamotrigine)

Be sure to read the page on how to deal with side effects common to all crazy meds
  • Normal insomnia can often be fixed by taking most or all of your Lamictal in the morning.
  • Insomnia of any kind tends to be dosage-dependent, but decreasing the dosage isn’t always an option.
  • As with all AEDs, the same applies to various cognitive effects. A 25mg reduction (or even increase) in your dosage might make all the difference in the world as far as clarity of thought, word finding, and similar problems are concerned.
  • As with Topamax, daily stretching helps most people with muscle aches.
  • Many people swear by biotin- and selenium-based products to deal with hair thinning or hair loss. Shampoos, supplements, or both. The studies and anecdotal evidence are all contradictory. Just be careful with any selenium supplements you take, because it’s really easy to take too much. One of the symptoms of selenium toxicity: hair loss.
  • Various skin problems can be treated with everyday lotions & ointments. Be careful with these as well, because…
  • Many of the benign rashes and assorted dermatological issues are caused or exacerbated by ingredients in soaps, shampoos, detergents, etc. You may have to change some, or all of the products you use. If you recently changed something and then had a rash, get rid of whatever is new and go back to whatever it was you used to use. Or do without.

Have I gone on about the rash long enough yet? Thanks to Lamictal kids with Lennox-Gastaut are able to live marginally normal lives, and skads of people with bipolar 2 and otherwise treatment-resistant forms of depressive disorders are able to function. Oh, and many of those depressed people started to feel a hell of a lot better in a couple of days. But when you ask teh intergoogles about it, you’d think the stuff was made out of poison ivy fermented in wet diapers.

Lamictal is not alone in this rash thing.

All AEDs can make you more susceptible to skin irritants and dermatological problems. Lamictal is just the worst when it comes to that. Contact dermatitis, eczema, and similar problems can be caused by any number of things. Some of the most likely sources are:

  • Soap
  • Cosmetics
  • Household cleaners
  • Fabric softener and dryer sheets
  • Clothing - either the fabrics or something the clothes came in contact with
  • Latex
  • Facial creams
  • Sunscreen

Because they contain:

  • Fragrances. Used in cosmetics, insecticides, antiseptics, soaps, perfumes, and dental products.
  • Formaldehyde. Used as a preservative in fiberboard (that new office smell), paints, medications, household cleaners, cosmetic products, and fabric finishes.
  • Quaternium 15. A preservative in self-tanners, shampoo, nail polish, sunscreen.
  • Neomycin sulfate. An antibiotic in first aid creams and ointments.
  • Several metals, especially cobalt chloride, nickel, and gold. While mostly used in the obvious places, cobalt chloride is also used in hair dyes and antiperspirants.
  • Poison ivy, poison oak, poison sumac, and other natural things that are outdoors and always trying to kill us.

Sometimes it really is Lamictal’s fault

In spite of all of the above, Lamictal, and, to a lesser extent, other AEDs, will give you a rash for no good reason. OK, there’s probably a good reason - Lamictal is a folate antagonist, and by messing with the absorption and distribution of folate through your system, your skin becomes susceptible to various dermatological problems. More often than not these rashes are not serious, but you can’t just ignore them. Once again - a rash means trouble if:

  • It itches
  • You have a fever

If you have one of two of the above symptoms along with the rash, call your doctor ASAP. If you have both you need to see a doctor (shrink, PCP, anyone with a license to practice real medicine on humans) immediately. If you are unable to see a doctor, have a high fever, and/or the rash is spreading quickly, call your doctor and head to the ER immediately with a bottle of Lamictal and an empty bottle8 of all the other meds you take, crazy or otherwise, so there are no mistakes about your cocktail.

How to avoid rash decisions

Eliminating common skin irritants from your life may prevent you from needlessly discontinuing Lamictal - or any other drug for that matter - due to something like contact dermatitis.
For even more information about household products, skin allergies and irritants see:

As has been recently pointed out to me, there has been all of one report of Lamictal-induced perfume sensitivity out of over 35,000 users. They’ve also found 99 reports on social media and the FDA’s side effect reports.9 Asking their patients about new perfumes and scented products when they present a rash, and warning them about how Lamictal (and other meds) can exacerbate or cause sensitivity to various products, has been recommended to prescribers. Also in this not-free article.



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References

  1. Lamictal’s Full US Prescribing Information

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Pros & Cons, Interesting Stuff Your Doctor Didn’t Tell You | Lamictal Index | Blackbox Warning & Noted Traits


1 If you have the luxury of both a job and being able to cope with your symptoms not being dealt with for however many days you need to wait in order to do this. Read enough of this site and you can tell I live in a fantasy world.

2 They're all tinea and the only differences in the species are where they happen to be on your body. The only difference in the various treatments with the same active ingredients are marketing and price. Compare all the ringworm, athlete's foot, and jock itch products at a large chain drugstore and ringworm treatments usually cost more than jock itch treatments that cost more than athlete's foot treatments with the same active ingredients and mostly the same inactive ingredients. You can apply the athlete's foot ointment wherever you want. Vaginal cream has the same active ingredient as many tinea treatments - clotrimazole - but at a far less concentration, so it would be more expensive to use.

3 In case you didn't read it on the previous page: Lamictal was originally developed as a folate antagonist, just like antimalarial medications, in order to determine if folate had anything to do with seizures. At least we know for sure why Lamictal messes with folate. It's not any good for malaria.

4 That's only a metaphor. Never flush any meds, crazy or otherwise, down the toilet. Donate them to a free clinic or take them to a pharmacy for proper disposal.

5 You're probably smarter than the average nutjob if you're reading this site. Crazier, too.

6 This may be due to Lamictal's usefulness in treating nocturnal frontal lobe seizures, especially the uncommon autosomal dominant nocturnal frontal lobe epilepsy.

7 As Topamax and Lamictal are both approved to treat Lennox-Gastaut syndrome, and are particularly good at dealing with atonic, or drop seizures, my guess is this side effect is a result of that. Sort of like how allergies are immune responses to germs that no longer exist, in that you get this side effect if you don't have atonic/drop seizures. So the next time you feel like bitching about this side effect, Google Lennox-Gastaut syndrome imagine what your life would be like if your kid had that. Unless you're in pain most of the day, day after day, shut up and take your meds.

8 Empty, because those bottles don't always come back. Or someone won't like what is in one of them and will be doing you a great favor by emptying it out. Yes, that has happened to me.

9 I have no idea what qualifies as "social media".


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 Monday, 18 April, 2016 at 15:51:56 by JerodPoorePage Author Date created
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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.




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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.
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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.
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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.
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‘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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