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Lamotrigine (Lamictal)

Lamotrigine (Lamictal) is a medication that has a variety of uses: the drug was introduced in 1994 as an anticonvulsant and anti-seizure medication, but thereafter has also been found to be particularly effective in preventing depressive mood episodes in the treatment of Bipolar I and Bipolar II Disorder. It is important to note that lamotrigine has not been shown to reliably decrease the occurrence of manic or hypomanic episodes, and has been in some cases observed to sometimes increase their occurrence.

Lamotrigine has been linked to skin rashes ranging from mild to severe.... In very rare cases, about 0.8-0.13% of patients may develop Stevens-Johnson Syndrome.

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Articles of Interest

Lamotrigine and Stevens-Johnson Syndrome Prevention

The most common triggers for SJS are medications such as NSAIDS, allopurinol, certain classes of antibiotics, and antiepileptics. Of the antiepileptics, one most commonly associated with SJS is lamotrigine, a pre-synaptic voltage-gated sodium channel inhibitor. The increased incidence of lamotrigine associated SJS has led to an FDA Blackbox warning to alert physicians and patients to its potentially harmful side effects.

The Birth of Lamotrigine

Usually these kinds of medical discoveries have their origins in animal models, laboratory studies, and academic research teams. But Dr. Weisler did all this as a solo private practitioner. His observations quickly caught the eye of the research community, and with their help he convinced GlaxoSmithKline to test lamotrigine out in an ambitious series of 12 controlled trials.

Day # 57: Lamotrigine

Lamotrigine is a mood stabilizer used in bipolar disorder and an anti-epileptic drug (AED) used for seizures.

Discovery and development of lamotrigine for bipolar disorder: A story of serendipity, clinical observations, risk taking, and persistence

The development of lamotrigine provides one example of the importance of prescience, patience and persistence in bringing a novel idea to clinical fruition.

How to Minimize Lamotrigine’s Adverse Effects

Lamotrigine is less likely to impair cognition than other mood stabilizers, and it may even confer cognitive benefits. It has improved verbal fluency, working memory, attention, and concentration in studies of bipolar disorder and healthy subjects. On the other hand, adverse cognitive effects are possible with lamotrigine. This usually manifests as word-finding difficulty and improves with dose reduction.

Is generic lamotrigine as good as Lamictal?

Moreover, if a patient has started on a generic from the beginning, and gets good symptom control, the whole issue is moot. So it won’t be long, if the generic continues to work as well as it has so far for me, before this whole issue is less concerning.

Lamictal: Break Out the Shovel

GlaxoSmithKline, manufacturer of lamotrigine (Lamictal), the antiepileptic drug used widely for bipolar disorder, happily hid clinical trial results which found Lamictal was no better than a placebo. Given recent findings about how often pharmaceutical companies selectively push positive results to publication in medical journals while suppressing negative results, this can hardly be considered a surprise. It is nonetheless instructive to examine how the published data on Lamictal paint a much rosier picture of the drug's efficacy compared to unpublished data.

Stevens Johnson Syndrome associated with Lamotrigine

The risk of developing SJS with Lamotrigine is rare and relatively predictable during the first few weeks of its use; clinicians prescribing this medication should however be aware of this high risk condition. Current evidence indicates that although Lamotrigine may cause a serious rash for which clinicians must continue to observe standard new dosing paradigms & practice precautions, in the case of non-serious rash, a re-challenge with Lamotrigine can also be considered in many cases.

What is Lamictal (Lamotrigine) and How Does it Help Manage Bipolar Disorder?

As you may already know, Lamictal changed and saves my life. It’s the only drug I’ve been able to take since I was diagnosed in 1995. I am always singing the praises about the drug. It comes with side effects for sure- the main one being a rash that can be serious. But it’s very, very rare. Many health care professionals are wary of Lamictal because of the rash, but I always remind people that a potential side effect is just that. If monitored correctly, the potential is small.

Resources

Lamotrigine

Lamotrigine is a type of medicine called a ‘mood stabiliser’ as it can reduce feelings of excitability and over-activity and reduce mood swings. It tends to work better on the low mood (depression) part of bipolar disorder. It is also taken by some people who have epilepsy, as it increases the effects of the calming transmitter GABA, leading to a reduction in seizures.

DailyMed

LAMICTAL® can cause serious rashes requiring hospitalization and discontinuation of treatment. The incidence of these rashes, which have included Stevens-Johnson syndrome, is approximately 0.8% (8 per 1,000) in pediatric patients (2 to 16 years of age) receiving LAMICTAL as adjunctive therapy for epilepsy and 0.3% (3 per 1,000) in adults on adjunctive therapy for epilepsy.

StatPearls

Lamotrigine can be used to treat the following partial seizures, primary generalized tonic-clonic seizures, bipolar I disorder maintenance and Lennox-Gastaut syndrome. Off-label uses include treating acute bipolar depression, fibromyalgia, schizophrenia, and unipolar depression.