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This information is not a replacement of full discussions of risks and benefits with your doctor

Other Names: Lamictal ( GlaxoSmithKline)

Principal Uses: Lamotrigine is used for the prevention of mood episodes in patients with Bipolar Disorder, predominantly by preventing depressive episodes. It is also used for epilepsy and some other neurological conditions.

Cost: Fully subsidized on doctor’s prescription.

Dose: For Bipolar disorder, recommended gradual dose increase slowly from 12.5mg/ day or 25mg on alternate day (week 1-2), 25mg/day (week3-4), 50mg/day in single or 2 divided doses (week5), 100mg/day in single or 2 divided doses (week6); Maximum daily dose usually 200mg/day though higher doses may be needed if combined some other medications (such as Carbamazepine)because it breaks down quicker.Sensitivity reactions can occur – this is rare but may be dangerous – the medication should be stopped if a rash develops.

How it works: Lamotrigine makes some nerve cells less likely to be activated when not needed.

Some Possible Side Effects: Skin rash, irritability, blurred vision, vomiting and diarrhea, headache. Less likely Agitation, Tiredness, Back pain, sleepiness, dizziness, tremors.

Precautions: Lamotrigine should be used with caution in patients with history of skin rash, kidney or liver disease, and some other conditions.
Caution is advised if driving or operating machinery.
Care should be taken when initiating therapy to avoid initial high doses and rapid dose increase.

Use in Pregnancy: Category B3/ C
Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed.
There are no well-controlled studies of pregnant women receiving Lamotrigine..
Women who are planning to become pregnant or who are pregnant while being treated on Lamotrigine should take folic acid supplement before conception and for the first 12 weeks of pregnancy. Specialist prenatal diagnosis including detailed mid-trimester ultrasound should be offered to pregnant women.
Lamotrigine concentration during pregnancy may fall and therefore dosage adjustments may be necessary.

Use in Lactation: Category L3
There are no controlled studies in breastfeeding women; however, the risk of untoward effects to a breastfed infant is possible or controlled studies show only minimal non-threatening effects. Drugs should be given only if the potential benefit justifies the potential risk to the infant.

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