Lamotrigine for epilepsy

Lamotrigine requires 2 to 3 daily doses. It is available in tablets.

It is not known exactly how lamotrigine prevents seizures.

Lamotrigine is used to treat a broad range of seizures. It helps control partial seizures, especially partial seizures with secondary generalization. It may also be effective in treating absence seizures and generalized tonic-clonic seizures.

Lamotrigine is used most often with other epilepsy drugs.

Lamotrigine has been approved for use in children ages 2 years and older who have Lennox-Gastaut syndrome and who have not responded to other drug treatment. Lamotrigine is usually added to the child's existing drug therapy. There are still some concerns about the safety of lamotrigine, but a smaller initial dose and slower increases in dosage may reduce some of the risks.

Lamotrigine, when added to another medicine being taken for epilepsy, can reduce the number of seizures in people with partial epilepsy that hasn't been controlled by one medicine alone.¹ Used alone, it may be as effective as carbamazepine or phenytoin when used to control partial or generalized seizures in adults.²

Most people tolerate lamotrigine very well. Common side effects include:

• Rash. Rash tends to occur more often in children than in adults and in people who are also taking valproic acid. On rare occasions, the rash may be severe and potentially life-threatening.
• Drowsiness.
• Difficulty falling or staying asleep (insomnia).
• Dizziness.
• Blurred or double vision.
• Headache.
• Nausea.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

It may take time and careful, controlled adjustments by you and your doctor to find the combination, schedule, and dosing of medicine to best manage your epilepsy. The goal is to prevent seizures while causing as few unwanted side effects as possible. After the most effective medicine program is determined, it is important that you follow it exactly as prescribed.

• Adverse effects. Lamotrigine treats a wide range of seizures, and most people tolerate it easily. It has fewer side effects than some of the older drugs (carbamazepine, phenytoin, phenobarbital) used to treat the same types of seizures. However, it does have the potential to cause a serious, even life-threatening rash. This side effect is rare in adults but somewhat more common in children. Gradually increasing the dose until the person is taking the full dose can lower the risk.
• Drug interactions Many medicines for epilepsy can interact with other medicines you may be taking. This means that your epilepsy medicine may not work as well, or it may affect the way another medicine you are taking works. Some of these interactions can be dangerous. It is important to tell you doctor about all the medicines, herbal pills, and dietary supplements you are taking. Lamotrigine is a good choice if you are taking birth control pills because it will not make the pills any less effective. But if you are taking birth control pills, you may need to take a higher dose of lamotrigine.
• Cost. Lamotrigine is expensive.
• Risk of birth defects. All medicines for epilepsy have some risk of birth defects. But the risk of birth defects needs to be carefully compared to other risks to the baby if the mother stops taking her epilepsy medicine. If you are thinking about becoming pregnant, it is important to plan ahead and talk with your doctor about the benefits and risks of taking epilepsy medicine during your pregnancy. It you are already pregnant, it is not too late. The best thing to do is talk to your doctor about your pregnancy before you make any changes to the medicines you are taking.
• Other concerns. For some people, it may produce side effects or carry risks that are not fully known yet. Report any unexpected side effects or problems to your doctor.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Citations

1. Ramaratnam S, et al. (2007). Lamotrigine add-on for drug-resistant partial epilepsy. Cochrane Database of Systematic Reviews (1).

2. Drugs for epilepsy (2005). Treatment Guidelines From the Medical Letter, 3(39): 75–82.