Lamictal

Lamictal is the brand name for lamotrigine, an anticonvulsant and mood stabilizer used to treat certain seizure disorders and bipolar disorder. In epilepsy, lamotrigine is prescribed as monotherapy or as an add-on therapy for partial seizures, and it can be used for generalized tonic-clonic seizures in some settings. In bipolar disorder, it is approved for maintenance treatment to delay relapse of mood episodes and is sometimes used as add-on therapy for depressive symptoms.

Lamotrigine’s mechanism involves inhibition of voltage-gated sodium channels and reduction of excitatory glutamate release, which helps stabilize neuronal activity. It is available in oral tablet form and as an orally disintegrating tablet. Dosing is individualized and started at a low level with gradual titration over several weeks to minimize the risk of rash. Dose adjustments may be needed in kidney or liver impairment and when taken with other interacting medicines.

Contraindications and cautions include hypersensitivity to lamotrigine. Caution is advised in liver disease, pregnancy, and breastfeeding, with dose adjustments and close monitoring as appropriate. Lamotrigine interacts with several medicines; notably, valproic acid can markedly increase lamotrigine levels, while enzyme-inducing antiepileptic drugs (such as carbamazepine or phenytoin) can lower lamotrigine levels, potentially requiring dose changes.

Common adverse effects include dizziness, somnolence, headache, nausea, and rash. A serious skin rash can occur, especially during early titration, and requires immediate medical attention and discontinuation. Rare cases of aseptic meningitis and hypersensitivity reactions have been reported.