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Lamotrigine
Brand Name: Lamictal
Overview
Lamictal is the brand name for lamotrigine (also known as LTG), an anticonvulsant
medication. It is chemically unrelated to other anticonvulsant medications.
Lamictal’s side effects are generally few and relatively benign. Lamictal is known
as a drug that is effective in people who were not helped by other, more traditional
medications, when used as an anticonvulsant or as a mood stabilizer.
Lamictal is not a cure for epilepsy, but this medication can help to control
epileptic seizures, and it is often used along with other medications for this same
purpose. Prescribing information for children as young as 2 years old is available.
Lamictal is FDA approved for used as a mood stabilizer as a maintenance therapy,
to prevent manic and depressive episodes. It seems to be effective in a large
proportion of patients who were not helped with other mood stabilizing drugs, and is
especially effective in bipolar depression.
Why
is this drug prescribed?
Lamictal is used to treat partial seizures in patients with epilepsy. Lamictal is also
used to treat absence, tonic, and atonic seizures.
Lamictal is also used to treat mood disordes that do not respond to other medication,
such as:
- Rapid cycling and mixed bipolar states
- Post-traumatic stress disorder (PTSD)
- Borderline personality disorder (BPD)
- Depersonalization disorder
- Schizoaffective disorder
- Depression
- Bipolar disorder, especially its depressive phase
Warnings
and Precautions
Children: Lamictal is used in children primarily for Lennox-Gastaut syndrome. The risk of
the side effect of a skin rash is higher in children under 16 than in adults. Sometimes the
rashes caused by Lamictal could be very serious or even fatal. This risk must be weighed
against the benefits of Lamictal and any rashes should be discussed with a pediatrician. The
risk of rash is usually only significant during the first six months of beginning Lamictal
therapy.
Rash is the most significant side-effect of Lamictal because in rare instances, it has
caused serious harm or, very rarely, death. Factors that increase the risk of a serious
rash include a high initial dosage of Lamictal, and use of valproic acid at the same time.
In the past the rash incidence, leading to Stevens-Johnson Syndrome, was high because of
high initial doses and failure to adjust the dose when given with valproate. Newer data
suggest that the incidence of a dangerous rash is much lower with current dosing guidelines.
Patients taking Lamictal should not try new shampoos, soaps, or detergents and should
avoid sun exposure so as not to increase the chance of an allergic reaction or development
of a rash which is not due to Lamictal, but would necessitate stopping the medication in
order to investigate the source of the rash. The appearance of any rash in a patient taking
Lamictal should be immediately reported to a doctor.
Dosage: adjustments to the dosage must be made by considering all medications that the
patient will be taking. The medications valproic acid, carbamazepine, phenobarbital,
primidone, and phenytoin must especially be taken into account and may be adjusted for
Lamictal.
Whenever possible, Lamictal should not be discontinued abruptly, but dosage should be
graudally tapered to minimize the risk of increased frequency of seizures.
Because Lamictal can cause dizziness, drowsiness, and vision problems, patients should
not engage in activities, such as driving or operating machinery, until they are certain
that Lamictal’s effects do not present a danger to themselves or others.
For Pregnant or Nursing Mothers: Lamictal’s effects have not been studied in pregnant
women, but studies on animals indicate that it can harm the fetus or cause miscarriage,
even in doses less than the equivalent of an overdose in humans. Pregnant women taking
Lamictal may be asked to take a folic acid supplement. Lamictal passes into breast milk,
but its effects on the infant are not well understood so breastfeeding is not recommended.
Contraindications
Lamictal should Not be used for people with an allergy or hypersensitivity to Lamictal.
Precautions
Lamictal may be used with caution in people with the following conditions:
- Kidney or liver disease – Lamictal may not be removed from the blood as quickly and dosage may need to be lowered.
- Thalassemia – Lamictal may lower your red blood cell production.
Adverse
Reactions
Lamictal may cause the following reactions:
- dizziness (more common in women)
- drowsiness or sleepiness
- headache
- nausea / vomiting
- constipation
- diarrhea
- blurred or doubled vision
- indigestion
- runny nose
- skin rash (more common in children) – always report to a doctor
- clumsiness or unusually poor coordination
- slurred speech
- weight loss
- insomnia
- anxiety
- confusion
- depression
- irritability or other mood or mental changes
- dry mouth
- weakness
- chest pain
- continuous, uncontrolled back and forth and/or rolling eye movements
- infection
Interactions
with Drugs and Other Substances
Drugs or substances that may interact with Lamictal include:
- Carbamazepine (Tegretol), Phenobarbital (Luminal), Phenytoin (Dilantin), Primidone (Mysoline), Valproic acid (Depakote) – these medications may change blood levels of Lamictal and dosage adjustment may be needed for one or both medications.
- Alcohol or other CNS depressants, including antihistamines hay fever medicine, cold medicine, sedatives, tranquilizers, sleeping pills or sleep aids, prescription pain medicine, narcotics, barbiturates, other medicine for seizures, muscle relaxants, and anesthetics, including some dental anesthetics – Lamictal may increase the depressant effects of these medicines.
Sources
http://www.healthtouch.com
http://www.healthsquare.com
http://www.rxmed.com
Use for treating mood disorders:
http://www.psycom.net/depression.central.lamotrigine.html
http://www.angelfire.com/fl5/bipolarnoise/News/Lamictal1.html
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