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Lamictal (lamotrigine) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) for treating adults with bipolar 1 disorder.
These insights are based on 637 comments about Lamictal from MyDepressionTeam members. These are the experiences of a small number of individuals and are not meant to be medical advice.
Lamictal is a type of medication called an anti-seizure medication that works by affecting sodium channels, which help nerve cells send signals. This may help steady nerve cell activity and change the release of certain brain chemicals.
In bipolar 1 disorder, the exact way it helps is not fully known, but it is used to help delay mood episodes. Doctors prescribe Lamictal when someone with bipolar 1 disorder needs long-term maintenance treatment after treatment for acute mood episodes with standard therapy.
Lamictal is taken by mouth, typically once or twice daily, with a slow dose increase over several weeks before reaching a maintenance dose. It comes in different forms, including regular tablets, tablets that can be swallowed, chewed, or mixed with liquid, and orally disintegrating tablets that dissolve on the tongue.
Follow the instructions for the exact form you are prescribed.
The recommended starting dose of Lamictal for bipolar 1 disorder is 25 milligrams every other day for weeks 1 and 2, then 25 milligrams daily for weeks 3 and 4, if taken with valproate.
For people who respond to treatment, the recommended maintenance dose is 100 milligrams daily if taken with valproate.
The recommended starting dose of Lamictal for bipolar 1 disorder is 25 milligrams daily for weeks 1 and 2, then 50 milligrams daily for weeks 3 and 4, if not taken with carbamazepine, phenytoin, phenobarbital, primidone, or valproate.
For people who respond to treatment, the recommended maintenance dose is 200 milligrams daily if not taken with those medicines.
The recommended starting dose of Lamictal for bipolar 1 disorder is 50 milligrams daily for weeks 1 and 2, then 100 milligrams daily in divided doses for weeks 3 and 4, if taken with carbamazepine, phenytoin, phenobarbital, or primidone and not with valproate.
For people who respond to treatment, the recommended maintenance dose is up to 400 milligrams daily in divided doses if taken with those medicines.
If these other medicines are started, stopped, or changed, doctors may adjust the Lamictal dose. If Lamictal is stopped, doctors usually lower the dose step by step over at least two weeks unless a faster stop is needed for safety.
This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.
These insights are based on 637 comments about Lamictal from MyDepressionTeam members.Members who use Lamictal often say that patience, consistency, and close communication with a doctor matter most. Many members also stress paying attention to side effects, especially early on or after dose changes, and speaking up quickly if something feels off.
Start low and increase slowly with your doctor.
“The thing with Lamictal is that you have to start at a very low dose and increase slowly over a few weeks until you get to the right maintenance dose for you.”
Tell your doctor right away about a rash or bad reaction.
“After one month, my body began to have a bad rash with hives. I have to stop taking Lamictal, which was really helping me.”
Give it time, because benefits may take a while.
“I take Lamictal, and it took a while for it to start working for me. Now that I have a dosage that works, it seems to be helping.”
Keep track of side effects, especially after dose changes.
“Had my Lamictal increased, and it didn’t agree with me, so had a really not good day yesterday from the side effects.”
Stay in touch with your doctor and advocate for yourself.
“You have to advocate for yourself. I told my doc that my current medicine was helping a bit but not quite cutting it. He suggested Lamictal as an add-on.”
Connect with others who understand life with bipolar 1 disorder. Join MyDepressionTeam for free.
In clinical trials of Lamictal for maintenance treatment of bipolar 1 disorder in adults, the most common side effects occurred in about 6 percent to 14 percent of people. These side effects were reported more often with lamotrigine than with placebo (an inactive treatment) in studies.
Lamictal can cause serious side effects that require immediate medical attention. These include:
Stopping Lamictal suddenly may raise the risk of seizures, even in people taking it for bipolar 1 disorder. Do not stop it unless your doctor tells you how.
Get medical help right away if you think you are having a serious reaction.
The GSK Patient Assistance Program (PAP) can help eligible individuals receive certain GSK prescription medicines at no cost. To learn more, visit the GSK Patient Assistance Program.
You might be eligible if you meet financial income criteria, are uninsured or have Medicare and meet other program requirements, live in the United States or Puerto Rico, and are being treated by a U.S. licensed healthcare provider.
Tell your doctor if you have any allergies to lamotrigine or any ingredients in Lamictal.
Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, and supplements.
Tell your doctor if you are of Asian origin and have had genetic testing showing you carry HLA-B*1502. This gene may raise the risk of serious skin reactions with Lamictal.
Tell your doctor if you take or plan to start or stop estrogen-containing birth control pills, hormone therapy, rifampin, or certain HIV medicines. These can change Lamictal levels, and your dose may need to be adjusted.
Do not take Lamictal if you have had a serious allergic reaction to lamotrigine or any of its ingredients.
Lamictal is also FDA approved to treat epilepsy.
If you are pregnant, planning to become pregnant, or breastfeeding while taking Lamictal, talk with your doctor about the risks and benefits. Lamictal levels may change during pregnancy and after delivery, so your dose may need to be checked.
If you breastfeed, your baby may need to be watched for rash, pauses in breathing, sleepiness, poor feeding, or poor weight gain. There is also a pregnancy exposure registry for those who take lamotrigine during pregnancy: the North American Antiepileptic Drug Pregnancy Registry at 888-233-2334 or the registry website.
These answers are fact-checked by our editorial staff.
How effective is Lamictal?
In two studies of adults with bipolar 1 disorder, Lamictal was better than placebo at delaying the time to a new mood change episode. A combined analysis showed a statistically significant benefit for delaying both depression and mania, with the effect being stronger for depression. It is used for maintenance treatment, not for treating an acute manic or mixed episode.
How long does Lamictal take to work for bipolar 1 disorder?
For bipolar 1 disorder, Lamictal is started slowly and usually reaches its target dose over several weeks. In adults not taking valproate or certain enzyme-inducing medicines, the schedule reaches 200 milligrams daily at week 6. The studies for bipolar disorder measured whether it delayed future mood episodes, rather than how quickly day-to-day symptoms improve.
Can Lamictal cause insomnia with bipolar 1 disorder?
Yes. In adults with bipolar disorder, insomnia was reported in 10 percent of people taking Lamictal in clinical trials. Other common side effects in bipolar disorder included nausea, somnolence, fatigue, rash, abdominal pain, and dry mouth.
What should I do if I stop taking Lamictal for bipolar 1 disorder and need to start again?
Do not restart Lamictal on your own. If Lamictal has been stopped for more than five half-lives, the usual recommendation is to follow the initial dosing schedule again. If it was stopped because of a rash, it generally should not be restarted unless the potential benefit clearly outweighs the risk. Ask your doctor first if you are considering restarting Lamictal.
On MyDepressionTeam, people share their experiences with bipolar 1 disorder, get advice, and find support from others who understand.
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