Lamotrigine for Epilepsy
Lamotrigine is available in tablets.
How It Works
It is not known exactly how lamotrigine prevents seizures.
Why It Is Used
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 is also used in children 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.
How Well It Works
When lamotrigine is added to another medicine being taken for partial epilepsy, it can help control seizures that haven't been controlled by one medicine alone.1
When it is used alone, lamotrigine can help 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 valproate. In rare cases, the rash may be severe and potentially life-threatening.
- Difficulty falling or staying asleep (insomnia).
- Blurred or double vision.
The U.S. Food and Drug Administration (FDA) has issued a warning on antiepileptic medicines and the risk of suicide and suicidal thoughts. The FDA does not recommend that people stop using these medicines. Instead, people who take antiepileptic medicine should be watched closely for warning signs of suicide. People who take antiepileptic medicine and who are worried about this side effect should talk to a doctor.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
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 side effects as possible. After you and your doctor figure out the medicine program that works best for you, make sure to follow your program 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. But 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 your 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.
- 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.
Ramaratnam S, et al. (2001). Lamotrigine add-on for drug-resistant partial epilepsy. Cochrane Database of Systematic Reviews (3).
Drugs for epilepsy (2008). Treatment Guidelines From The Medical Letter, 6(70): 37–46.
|Primary Medical Reviewer||Susan C. Kim, MD - Pediatrics|
|Specialist Medical Reviewer||Steven C. Schachter, MD - Neurology|
|Last Revised||August 26, 2011|