Handouts · Medications
Lamotrigine (Lamictal)
A mood stabilizer especially good at preventing bipolar depression. The dose is increased slowly to protect against a rare but serious rash.
What It Is
Lamotrigine helps prevent the depressed phase of bipolar disorder and is generally well tolerated — little weight gain or sedation.
It is raised slowly over several weeks for an important safety reason (see the warning).
How to Take It
Follow the slow step-up schedule exactly — going too fast raises the risk of a serious rash.
Take with or without food. If you miss several days, call before restarting — you may need to re-titrate from a low dose.
Black Box Warning — Serious Rash
Lamotrigine can rarely cause a life-threatening rash (Stevens-Johnson syndrome), most often in the first 8 weeks or if the dose is raised too quickly.
Stop the medicine and seek care immediately for any rash, especially with blisters, peeling, mouth/eye sores, facial swelling, or fever.
Common (Usually Mild) Side Effects
- Headache, dizziness.
- Nausea.
- Blurred or double vision.
- Trouble sleeping.
Serious — Seek Care Now
- Any new rash — do not wait; call us or seek care.
- Rash with fever, swollen glands, or facial swelling (a hypersensitivity reaction).
- Signs of infection with easy bruising (very rare blood problems).
Alcohol & Interactions
Limit alcohol.
Levels are strongly affected by other drugs: valproate roughly doubles lamotrigine (so the dose is lower and slower), while birth control pills and carbamazepine lower it. Tell us about any changes.
Monitoring
No routine blood tests are needed for most people.
The main safeguard is watching for rash, especially in the first two months, and following the titration schedule.