Lamictal for Bipolar (Lamotrigine)

by Sarah from Bipolar-Lives
(US)

US BRAND NAME: Lamictal

GENERIC NAME: Lamotrigine

TYPE: Anticonvulsant and Mood Stabilizer

USE: Treatment of bipolar depression. Its main use originally as to control seizures in the treatment of epilepsy. It is now known to be effective in the treatment of bipolar disorder. Lamictal is important because it treats bipolar depression without triggering mania, hypomania, mixed states, or rapid-cycling. It has not demonstrated efficacy in the treatment of acute mania.

COMMENTS: An emerging gold standard in treating bipolar is a combination of Lamictal and lithium. Popular because it is very effective as an antidepressant and is almost unique amongst bipolar meds in that it does not cause weight gain.

There is a low has extremely low risk of side effects - other than the potentialy deadly rash.

According to Dr Jim Phelps:
"Unfortunately, it does not have reliable anti-manic effects, so it's not enough, alone, for Bipolar I. But for Bipolar II, it can be fantastic -- indeed, the holy grail: 100% symptom control, 0% side effects."

Lamictal is a good choice where your main symptom is depression and you are afraid of weight gain.

In terms of the rash, it is more leikely to be the severe SJS type if it appears above the neck, around or in the mouth, in soft tissue such as mucous membranes of mouth, nose, eyes, or if it appears on the face. Below the chin is more likely to be an "ordinary" rash which may go away if you are patient and reduce your dose for a while before slowly increasing to therapeutic levels.

EVIDENCE: According to Consumer Reports and the British Medical Journal, people with bipolar depression who take lamotrigine are more likely to find that their symptoms get better or go away. Evidence shows the benefits usually outweigh the harms.

SIDE EFFECTS: Include but not limited to: Skin Rash, Blurred vision, Diarrhea, Dizziness, Double vision, Headache, Nausea.

CAUTIONS: Along with the risk of an unpleasant skin rash, there is also risk of SEVERE rash including Stevens-Johnson syndrome - this can be fatal. Very low starting dose and very slow increase of dose seems to be best way to prevent any of the skin rash side effects.