lamotrigine

A medication used to treat partial seizures.

Generic Name: Lamotrigine (la-MOE-tri-jeen)

Side effects:

• drowsiness
• nausea
• vomiting
• double vision
• blurred vision
• headache

If a person taking lamictal develops a skin rash, hives, fever, facial swelling, painful sores in the mouth or around the eyes, swelling of lips or tongue, or an increase of seizure, they should contact their doctor IMMEDIATELY.

Dosage range: The usual adult maintenance dosage is 100 to 150 mg per day in two divided doses or 300 to 500 mg per day in two divided doses, depending on other antiepileptic drugs taken in conjunction with lamictal. Dosage range may vary greatly per patient.

Lamictal has seen increasingly widespread use as a highly effective treatment for both Bipolar I and Bipolar II disorders.

It is an anticonvulsant that differs radically from others of its kind. I'll leave the fine details regarding the way it interacts with the brain to someone more qualified to write about them - chemically, it deals with neurotransmitters differently than other anticonvulsants, and its side effects are suprisingly few and weak when present. The most common is a light headache. Discontinuation of the drug has not been known to cause major withdrawal problems outside of the scope of removing any anticonvulsant, and accidental overdose is almost unheard of. There is a ridiculously small chance of developing a very serious rash across the upper body, concentrated around the neck. I have read that the chances are around 8 in 1,000 in adults, though I have been told by doctors that 9 in 10,000 is a better figure.

As is the case with many mood stabilizing drugs, researchers are not entirely sure as to why it works well in treating bipolar disorder, especially given its initial development as an anti-epilepsy drug. It is relatively new, which makes hard data on it difficult to pin down. However, patients who have not traditionally responded well to other treatments have been known to show a good response to Lamictal.

When taken as a mood stabilizer, the dosage of Lamictal is different; patients are typically started between 15 and 25 mg, stabilizing between 100 and 200.

Lamotrigine was approved by the FDA in December 1974. It is marketed in the U.S. and most of Europe as Lamictal by the British multinational healthcare company GlaxoSmithKline. GlaxoSmithKline's official U.S. Lamictal prescribing information can be found here. "Lamictal" in the U.S. has the brand names Lamictal (tablets 25, 100, 150, and 200 mg), Lamictal CD (chewable, 2, 5, and 25 mg), Lamictal ODT (orally disintegrating 25, 50, 100, and 200 mg), and Lamictal XR (extended release, 25, 50, 100, 200, 250, and 300 mg).

Lamictal is a pregnancy category C drug in the U.S. ("Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks") and pregnancy category D in Australia ("Drugs that have caused, are suspected to have caused - or may be expected to cause - an increased incidence of human fetal malformations or irreversible damage. These drugs may also have adverse pharmacological effects").

I suffer from Fabry Disease. The most prominent symptom in my case and the symptom that helped me and my doctor to reach the correct diagnosis was pain in my hands and feet, acroparesthesia (pain in the extremities). My acroparesthesia was unpredictable in "stable" controllable situations (not exercising, not higher temperature environment, which tend to lead to or exacerbate the pain). Sometimes (for hours or more rarely, even days) the pain would be dormant, but would come on suddenly and occur constantly or sporadically for minutes, hours, or days.

The effective dose in my case for eliminating the pain seems to be Lamictal tablet 100mg at morning and 100mg in the evening. Anything below that seems less effective or ineffective at lessening or eliminating the pain. I have personally experienced no side effects from taking Lamictal. Before she prescribed Lamictal, my first doctor prescribed me Neurontin (Gabapentin) but this did nothing for the pain. It was then that I was put on Lamictal, which stopped the pain in its tracks. My second doctor tried me out on Lyrica (Pregabalin) (stopping the Lamictal temporarily) but this medication also had absolutely no effect on the pain.

Across the internet I have come across personal accounts of Lamictal helping with pain from Trigeminal Neuralgia and cluster headaches. Conversely, note that side effects of Lamictal can include abdominal pain and painful menstrual periods.

An article on "Lamotrigine in the treatment of pain syndromes and neuropathic pain" can be found here.

Sources:
http://www.medicinenet.com/lamotrigine/article.htm
http://en.wikipedia.org/wiki/Lamotrigine
http://en.wikipedia.org/wiki/Pregnancy_category