Lamotrigine

Lamotrigine

Lamotrigine, a potent anticonvulsant and mood stabiliser, has gained significant attention in the medical community. This versatile drug affects the brain's electrical activity, helping to control seizures and stabilise mood swings in individuals with these challenging conditions.

Let's explore the various uses of lamotrigine and the proper dosing of tablet lamotrigine, as well as discuss its potential side effects. 

What is Lamotrigine?

Lamotrigine, also known by the brand name Lamictal, is a powerful medication that doctors prescribe to treat epilepsy and stabilise mood in bipolar disorder. This versatile drug belongs to the phenyl triazine class of antiepileptic medications, making it chemically distinct from other anticonvulsants. Doctors consider lamotrigine a first-line treatment for various types of seizures. 

Lamotrigine Uses

Lamotrigine tablets have a significant role in managing various neurological and psychiatric conditions. 

Epilepsy Treatment 

The medical community considers it as a first-line treatment for certain types of seizures, including:

• Primary generalised tonic-clonic seizures
• Simple and complex partial seizures
• Focal-onset tonic-clonic seizures

Lamotrigine has proven effective in managing Lennox-Gestaut syndrome, a severe form of epilepsy that originates in childhood.

Bipolar Disorder Management

Lamotrigine helps to stabilise mood swings in adults with this condition. Specifically, lamotrigine has shown effectiveness in:

• Treating rapid-cycling bipolar depression
• Maintaining stability in bipolar disorder type I

How to Use Lamotrigine Tablet

Lamotrigine can be taken with or without food. Patients typically take it once or twice daily, depending on their prescription. For those taking it twice daily, it's advisable to space the lamotrigine doses evenly throughout the day, such as in the morning and evening.

• Standard tablets: Swallow the tablet whole with water. Do not chew.
• Chewable dispersible tablets: These can be swallowed whole, chewed, or dispersed in liquid. If chewed, follow with a small amount of water or diluted fruit juice. To disperse, add the tablet to a teaspoon of water or diluted fruit juice, wait for it to dissolve (about 1 minute), then swirl and swallow immediately.
• Orally disintegrating tablets: Remove the tablet from the blister pack with dry hands. Place it on the tongue and allow it to melt. Swallow with or without water once dissolved.
• Extended-release tablets: Swallow whole. Do not break, crush, or chew.

Side Effects of Lamotrigine Tablet

Tablet lamotrigine, like all medications, can cause several side effects. While only some experience them, being aware of potential adverse reactions is crucial. Most side effects of lamotrigine wear off over time, but this process can take several weeks or months.

Common side effects include:

• Headaches
• Drowsiness and dizziness
• Nausea and vomiting
• Blurred or double vision
• Increased agitation or irritability
• Skin rash

In rare cases, lamotrigine can cause more serious side effects that require immediate medical attention. These include:

• Stevens-Johnson syndrome manifests as flu-like symptoms followed by a painful rash and blistering.
• A small number of people may experience thoughts of self-harm or suicide, particularly in the early stages of treatment.
• Irregular heartbeat
• Severe headache, stiff neck, fever, and sensitivity to light
• Easy bruising or unusual bleeding may indicate a blood-related side effect.
• Lamotrigine may also cause hemophagocytic lympho-histiocytosis, a rare but life-threatening condition.
• Aseptic meningitis is a serious but rare condition associated with lamotrigine use.

Precautions

Regular medical check-ups are crucial, especially during the initial months of treatment. The following are some precautions a user should be aware of:

• Pregnant & breastfeeding women should talk to their doctor regarding this drug usage.
• Women using hormonal contraceptives should consult their doctor before starting or stopping these products while on lamotrigine. 
• Older adults are more susceptible to its side effects.
• Lamotrigine can increase the effects of alcohol and other central nervous system depressants. 
• Patients with certain systemic conditions, such as kidney diseases, liver insufficiency, and cardiovascular conditions (irregular heartbeat or heart block), may exercise precautions.
• Patients should seek immediate medical guidance if they develop signs of a serious adverse reaction, such as skin rash, fever, flu-like symptoms, and swollen glands, or if their seizures worsen. 
• Patients should avoid or limit high-sugar foods containing aspartame, caffeinated beverages, and alcohol, as these may exacerbate symptoms of epilepsy or bipolar disorder. 
• Patients should not discontinue lamotrigine without consulting their doctor. Abrupt cessation may cause seizures to return or occur more frequently. 

How Lamotrigine Tablet Works

Lamotrigine's mechanism of action is multifaceted, involving sodium and calcium channel modulation, neurotransmitter regulation, and potential neuroprotective effects. This complex interplay of actions explains its efficacy in treating epilepsy and bipolar disorder and suggests potential for use in other neurological conditions.

Can I Take Lamotrigine with Other Medicines?

Certain medications can affect the levels of lamotrigine in the body. These include:

• Atazanavir
• Antiseizure drugs, such as carbamazepine, phenobarbital, phenytoin, primidone, and valproic acid
• Oral contraceptives containing oestrogen
• Phenytoin
• Phenobarbital
• Primidone
• Rifampicin

Patients should exercise caution when combining lamotrigine with other medicines that affect the central nervous system. These include:

• Antipsychotics drugs
• Benzodiazepines
• Opioids
• Other antiepileptic drugs

Dosing Information

For adults with bipolar disorder, the initial dose is typically 25 mg once daily for two weeks, followed by 50 mg once daily for two weeks. 

In epilepsy treatment for adults, the dosing is more complex. For patients not taking valproic acid but taking other enzyme-inducing antiepileptic drugs (AEDs), the initial dose is 50 mg once daily for two weeks, then 100 mg divided into two doses daily for two weeks. For those not taking any enzyme-inducing AEDs or valproic acid, the starting dose is 25 mg once daily for two weeks, then 50 mg once daily for two weeks, with a maximum dose of 375 mg daily.

Conclusion

While lamotrigine has proven benefits, it's crucial for patients to use it under close medical supervision. Regular check-ups and open communication with doctors are essential to ensure safe and effective treatment. By understanding the proper use, potential side effects, and necessary precautions, patients can maximise the benefits of lamotrigine while minimising risks, ultimately improving their quality of life.

FAQ's

1. What is the drug lamotrigine used for?

Lamotrigine serves as a versatile medication with multiple applications in the field of neurology and psychiatry. Its primary uses include:

• Epilepsy treatment
• Bipolar disorder management

2. What is the most common side effect of lamotrigine?

Lamotrigine, like all medications, can cause various side effects. The most common side effects of lamotrigine include:

• Headaches
• Drowsiness and dizziness
• Blurred or double vision
• Nausea and vomiting
• Skin rash

3. Who should not take lamotrigine?

While lamotrigine helps manage epilepsy and bipolar disorder for many people, certain groups of people should exercise caution or avoid taking this medication:

• People allergic to lamotrigine or any of its ingredients 
• Pregnant women
• Breastfeeding mothers
• Individuals with autoimmune diseases, blood disorders, heart problems, and kidney or liver insufficiency should inform their doctor before starting lamotrigine.
• Those with a history of depression or suicidal thoughts
• Children under two years old

4. Is lamotrigine better at night?

The timing of lamotrigine intake can vary and depends on patient factors and the specific prescription. Here are some considerations:

• If lamotrigine is prescribed once a day and causes sleepiness, taking it at night may be beneficial.
• For those prescribed lamotrigine twice a day, it's advisable to space out the doses throughout the day—for example, one dose in the morning and one in the evening.
• Some people may find that lamotrigine keeps them awake. In such cases, morning intake might be more suitable.
• Regardless of the timing, it's crucial to take lamotrigine consistently at the same time(s) each day.

5. Why is lamotrigine taken at night?

Lamotrigine is often taken at night for several reasons:

• If lamotrigine causes drowsiness, taking it at night can help minimise daytime sleepiness and its impact on daily activities.
• For once-daily dosing, nighttime administration can be easier to remember and incorporate into a bedtime routine.
• Taking lamotrigine at night may help some people better manage specific side effects that could be disruptive during the day.
• For some individuals with epilepsy, nighttime dosing may provide better seizure control, especially for those who experience seizures during sleep or upon waking.

Disclaimer: The information provided here is not meant to substitute an advice from a healthcare professional. The information is not intended to cover all the possible uses, side-effects, precautions, and drug interactions. This information is not intended to suggest that using a specific drug is suitable, safe, or efficient for you or anyone else. The absence of any information or warning regarding the drug should not be interpreted as an implicit guarantee from the organisation. We strongly advise you to consult a doctor if you have any concerns about the drug and never use the medication without a doctor’s prescription.