Patient handout
Lamotrigine (Lamictal)
You have been prescribed lamotrigine. This page explains what it is, what to expect, and when to call.
What it is
Lamotrigine is a mood stabilizer used to prevent the depressive episodes of bipolar disorder. It is also a seizure medication. It is not sedating, does not cause weight gain, and needs no blood-level checks, but it must be started very slowly to avoid a rare serious rash. Follow the starting schedule exactly.
How to take it
- Take it once a day, at the same time, with or without food. Follow the written step-up schedule exactly; the dose rises every one to two weeks.
- If you miss more than three days in a row, do not restart at your usual dose. Call us; the schedule has to begin again from the start.
- If you miss a single dose, take it when you remember unless the next dose is close. Do not double up.
- Tell us before starting or stopping birth control pills or valproate; both change lamotrigine levels and the dose has to be adjusted.
What to expect, and when
- Weeks 1 to 6: the dose is still climbing. Little benefit yet; this phase is about safety.
- Weeks 6 to 10: once at the target dose, mood stability and fewer depressive dips often begin to show.
- After that: it works best taken consistently for the long term, as prevention.
- It does not treat mania well on its own, and it is not an as-needed medication.
Common side effects
Headache, dizziness, nausea, sleepiness or insomnia, blurred or double vision, and tremor. Most are mild and fade. A mild rash without other symptoms still needs a same-day call.
Call the office the same day if
- Any new rash, especially with fever, sore throat, mouth or eye sores, swelling of the face, or blistering: stop the medication and call the same day. If severe, go to the emergency room. This is rare, most often in the first eight weeks, and is the reason for the slow start.
- Fever, swollen lymph nodes, or yellowing of the skin or eyes
- Unusual bruising or bleeding
- Severe headache with a stiff neck, or confusion
- New or worsening thoughts of hurting yourself
Stopping
Do not stop lamotrigine suddenly unless told to for a rash. Abrupt stopping can trigger mood episodes and, in people with seizures, seizures. We taper over several weeks together.
Good to know
- Carry the step-up schedule with you until you reach the full dose, and keep refills ahead of time so days are not missed.
- Tell other prescribers and your pharmacist. Valproate, carbamazepine, rifampin, and estrogen-containing birth control all change lamotrigine levels.
- If you are pregnant, planning pregnancy, or breastfeeding, tell us. Lamotrigine is one of the better-studied mood stabilizers in pregnancy, and doses often need adjusting.
Questions about this medication?
Alice Tran Psychiatric Care · 3060 Williams Drive, Suite 300, Fairfax, VA 22031
Call: (703) 791-9099 · Text: (703) 791-9031 · info@alicetrannp.com · alicetrannp.com
This handout is for education and is not a substitute for the instructions you received at your visit. Follow the dose on your prescription label. If anything here differs from what you were told, call the office. In an emergency, call 911. If you are in crisis, call or text 988.