Lamotrigine for epilepsy

Examples

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Brand Name	Chemical Name
Lamictal	lamotrigine

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

How It Works

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It is not known exactly how lamotrigine prevents seizures.

Why It Is Used

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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 but may also be used alone to treat epilepsy. Lamotrigine may also be used to treat people with newly diagnosed epilepsy.

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.

How Well It Works

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Lamotrigine reduces seizures in over half of those who add it to their drug therapy.¹ Used alone, it may be as effective as carbamazepine or phenytoin when used to control partial or generalized seizures in adults.²

Side Effects

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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.)

What To Think About

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It may take time and careful, controlled adjustments by you and your doctor to find the combination, schedule, and dosing of medication to best manage your epilepsy. The goal is to prevent seizures while causing as few unwanted side effects as possible. Once the most effective medication 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.
• Cost. Lamotrigine is expensive.
• Other concerns. Lamotrigine is a good choice if you are taking birth control pills because it will not make the pills any less effective.

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. If you are pregnant or thinking about becoming pregnant, talk to your doctor before taking this medicine.

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

References

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Citations

1. Ramaratnam S, et al. (2005). Lamotrigine add-on for drug-resistant partial epilepsy. Cochrane Database of Systematic Reviews (1). Oxford: Update Software.

2. Drugs for epilepsy. (2003). Medical Letter on Drugs and Therapeutics, 1(9): 57–64.

Credits

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Author	Monica Rhodes
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman
Primary Medical Reviewer	Michael J. Sexton, MD - Pediatrics
Specialist Medical Reviewer	Steven C. Schachter, MD - Neurology
Last Updated	November 11, 2005