Lamictal Side Effects: A Comprehensive Guide

Lamictal Side Effects: A Comprehensive Guide

Authored by Monique Deluge, / Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS
Last Updated: November 27, 2023


Lamictal, generic name lamotrigine, is an anticonvulsant safe for use in adults and children. It is prescribed to people diagnosed with epilepsy who experience focal seizures, tonic-clonic seizures, or other seizures associated with Lennox-Gastaut syndrome (LGS). For those who experience generalized tonic-clonic seizures, Lamictal is considered a first-line treatment. It is likewise effective at treating partial seizures, such as absence seizures, myoclonic seizures, and atonic seizures. Lamictal is also used to regulate mood in people with bipolar disorder by preventing or reducing their episodes of recurrent depression.

Lamictal is available in tablet form. Extended-release tablets can be taken by adults and children over 13, while the disintegrating tablet is usually prescribed to patients with bipolar disorder. This article is a comprehensive guide to Lamictal’s side effects and will help you determine whether Lamictal treatment could be beneficial to you.

Depression and mania

Lamictal is a mood stabilizer prescribed for people suffering from depression or manic episodes (like those experienced with bipolar disorder). When taking Lamictal, it is important to monitor the signs and symptoms of depression and mania, as Lamictal sometimes worsens mood fluctuations and depressed behavior.

Symptoms of depression include:

  • Depressed moods, including sadness, hopelessness, and helplessness
  • Feelings of worthlessness, guilt, and self-pity
  • Loss of interest in previously enjoyable activities
  • Sleeping or eating more or less than usual
  • Low energy and difficulty concentrating
  • Thoughts of death
  • Psychomotor agitation, which is characterized by rapid talking and movements that serve no purpose, such as pacing and toe-tapping
  • Psychomotor retardation, which is characterized by a feeling of moving in slow motion

Symptoms of mania include:

  • Irritability
  • A feeling of being “high”
  • Increased self-esteem
  • Decreased desire to sleep
  • Excessive speech
  • Racing thoughts
  • Impaired focus
  • Engaging in behaviors that are risky or could have bad consequences, such as excessive spending or fast driving

Other Lamictal uses

Sometimes, prescription drugs are used off-label, which means they are prescribed for an unapproved purpose or age group or in an unapproved dosage or form of administration. Lamictal is used off-label to treat the following medical conditions:

It is also prescribed off-label to treat the following treatment-resistant psychiatric disorders:

Overview of Lamictal’s side effects

An adverse effect, also known as a side effect or adverse reaction, is an undesirable and unintended reaction to a drug. Adverse reactions are often mild, and many require no medical attention because they resolve on their own with time. However, severe or long-term side effects may require continual monitoring by a healthcare professional. Because individuals react to medications differently, not everyone experiences the same side effects.

Lamictal’s common adverse effects

While Lamictal is generally well tolerated by most users, some experience side effects. When they do occur, Lamictal side effects usually present during the initial few weeks of treatment.

Here are some common side effects you may notice when taking Lamictal:

  • Chest pain, discomfort, or tightness
  • Breathing pain or irregular breathing
  • Double vision
  • Skin rash
  • Nausea
  • Vomiting
  • Pale skin
  • Skin rash
  • Weight gain
  • Unusual tiredness or weakness
  • Back pain
  • Difficulty falling asleep
  • Weakness
  • Throat sores

This list is not exhaustive, as some users experience other symptoms. Be sure to record your experiences and inform your doctor of any side effects you notice, as some may warrant treatment, especially in those with poor health status.

Lamictal’s rare adverse effects

It is important to note that in rare cases, Lamictal causes side effects that require emergency medical care. Call your doctor immediately if you experience any of the following:

  • Skin sores with persistent bleeding
  • Cough
  • Joint pain
  • Memory loss
  • Red or irritated eyes
  • Dark urine
  • Yellow skin or eyes
  • Sudden weight gain or weight loss

These reactions are atypical and will not present in most Lamictal users. However, it’s important to closely monitor changes in your body when starting any new treatment so you can relay this information to your healthcare provider.

Lamictal’s severe and long-term adverse effects

Some drugs have the potential to cause severe side effects. Using a prescription medication for an extended period also increases the risk of developing long-term side effects.

Lamictal can cause serious and long-term adverse effects that can be fatal if left untreated. Close monitoring by family members and frequent physician follow-ups are therefore necessary to properly manage side effects and recognize worsening symptoms. Frequently reported serious side effects of Lamictal include severe skin rash, serious allergic reactions, unusual bleeding, and worsening seizures.

You should seek emergency medical attention if you or your loved one taking Lamictal experience the following severe or long-term side effects:

  • Life-threatening skin reactions (more common in children than adults) that begin with fever, throat sores, and fatigue, usually within a few weeks of starting Lamictal. These include:
    • Steven-Johnson syndrome, which manifests as burning skin pain, mouth or lip ulcers, and mouth swelling.
    • DRESS syndrome, which includes an itchy rash all over the body, facial swelling, and swollen and painful lymph nodes.
    • Toxic epidermal necrolysis, which presents as red, shedding skin that results in large blisters.
  • Hemophagocytic lymphohistiocytosis, which causes yellowing of the skin and eyes, fever, skin rash, and enlargement of the spleen and liver (which can be felt when pressing the abdomen).
  • Aseptic meningitis, which manifests as fever, a general ill feeling, a stiff neck that is painful when rotated, and reduced appetite.
  • Seizures of increased frequency and/or intensity.
  • Blood disorders, such as leukopenia and thrombocytopenia, which cause unusual bleeding, and increased risk of infection.
  • Severe suicidal thoughts or behaviors, worsening depression or hopelessness, a lack of interest in previously enjoyable activities, aggressiveness, and/or acting on dangerous thoughts.
  • Serious arrhythmias or heart attack (which are more common in those with underlying heart problems).

Common questions about Lamictal

Precautions when using Lamictal

Although created to improve health, all drugs have potential to cause harm. Paying attention to safety guidelines and precautions can help you avoid these risks. Here are a few precautions to consider when using Lamictal:

  • Quickly increasing the dosage or taking the drug more often than prescribed can lead to overdose. Seek medical attention immediately if you suspect overdose, as prompt medical intervention is essential to mitigate potential complications of a Lamictal overdose, which include increased seizures and altered mental states. Here are a few signs of Lamictal overdose:
    • Loss of consciousness, potentially leading to coma
    • Impaired coordination, stumbling, and falling
    • Blurred vision
    • Increased seizures
    • Uncontrolled, repetitive eye movements
    • Rapid heartbeat
    • Slurred speech
    • Severe headache
    • Dry mouth
  • Lamictal may increase the effects of alcohol and central nervous system depressants, such as antihistamines, cold or allergy medicines, sedatives, tranquilizers, and sleep aids. It is best to avoid these substances when using Lamictal.
  • Potentially life-threatening skin reactions may occur. The risk is increased in those who:
    • Are currently taking a valproate-containing medication (e.g., Depacon, Depakote, Depakene, or Stavzor)
    • Have a history of hypersensitivity to other anticonvulsants
    • Take more than the recommended dose of Lamictal or increase the dosage more quickly than recommended
  • Since Lamictal can cause unusual tiredness and dizziness, do not drink or operate heavy machinery until you know how Lamictal affects you.

Alternatives to Lamictal

If Lamictal is not the right treatment for you, here are are few alternative medications your healthcare professional may discuss with you:

Managing the side effects of Lamictal

Practical tips for coping with Lamictal’s side effects

When starting any new treatment, coping with side effects can be difficult. Managing them requires lifestyle changes, regular communication with your healthcare professional, and continual monitoring for worsening symptoms. You will need the help of your loved ones, especially when coping with severe or long-term side effects. Here are some general tips for coping with Lamictal’s side effects:

  • Maintain continual dialogue with your healthcare provider and set frequent follow-up visits so you can be advised on how to cope with your specific side effects.
  • To prevent severe skin rash or allergic reactions, you may be prescribed a low dose that is gradually increased as needed over time. If you experience significant skin changes, you may have to discontinue the drug.
  • It is best to avoid Lamictal if you currently have a viral infection or have recently received a vaccine.
  • Make healthy diet and lifestyle changes. Some exercises and physiotherapy can help you cope with pain, and incorporating fruits and vegetables into your diet can help maintain overall good health.
  • If you find that you experience memory problems or lose focus easily while on Lamictal, try setting reminders on your phone or place sticky notes around your house.

Lamictal drug and food interactions

As when taking any medication, be cautious regarding the medications you take and the food you eat when taking Lamictal. Such care is important when using Lamictal, as some food and medications can trigger seizures, affect Lamictal’s absorption, or worsen its side effects. Here are some of Lamictal’s food and drug interactions that you should discuss with your doctor:

  • Valproic acid can increase the risk of serious skin reactions when taken with Lamictal
  • Carbamazepine and phenytoin increase the clearance of Lamictal from the blood, decreasing its effectiveness
  • Some oral contraceptives may interact with Lamictal
  • Grapefruit increases the concentration of Lamictal in the blood, increasing the risk of adverse effects

The importance of treatment adherence

Managing epilepsy or bipolar disorder can be difficult, especially with the high cost of prescription drugs. However, staying adherent with your Lamictal treatment plan will ensure effective remission of your symptoms. Taking your medication regularly is important, as frequent missed doses can cause symptoms to worsen.

With The Rx Advocates, you can reduce your out-of-pocket costs so you never have to worry about running out of Lamictal. We can help you apply for the Lamictal patient assistance program, which offers far greater savings than coupons or other discounts. With this program, you are guaranteed monthly access to your medication at a fraction of its retail cost, whether or not you are commercially insured. Contact us today to find out if you qualify!

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