For many years, those with bipolar disorder had few treatment options. If lithium was ineffective or caused unwanted side effects, there were few directions to turn. These days, many drugs initially synthesized to control seizures are now being used to treat bipolar disorder effectively. Lamictal is gaining in popularity as a treatment, and while it is showing great promise, it also has serious side effects.
Chemical Effects
It is not known precisely how Lamictal, or lamotrigine, works as a mood stabilizer. Originally synthesized to treat epilepsy and other seizure disorders, it came to light that Lamictal (and other anti-convulsants) stabilize mood in people with bipolar disorder. Netdoctor explains how Lamictal works for treating seizures, "Lamotrigine prevents epileptic fits by preventing excessive electrical activity in the brain. It does this by preventing sodium from entering nerve cells when they begin to fire rapid and repetitive electrical signals." That buildup of sodium in the nerve cells allows electrical signal to build up and pass on to other nerve cells. Because lamotrigine prevents the brain's electrical activity is stabilized.
Psychiatrists frequently prescribe Lamictal "off-label" for the treatment of Bipolar Disorder. This means that this is not the illness Lamictal was created and approved to treat. Netdoctor states that it is not fully understood how lamotrigine works in this illness, but is thought to reduce the amount of glutamate in the brain.
Efficacy of Lamictal
RxList reports two studies using Lamictal in the maintenance treatment of bipolar disorder. In both studies, patients were treated with 200 to 400 milligrams of Lamictal either alone or in conjunction with another medication. Patients receiving Lamictal had longer periods free from mood episodes than those taking placebos (sugar pills). No additional benefit was derived with higher dosage. RxList concludes, "A combined analysis for the two studies revealed a statistically significant benefit for Lamictal over placebos in delaying the occurrence of both depression and mania, though the finding was more robust for depression.
Taking Lamictal
According to RxList, "The goal of maintenance treatment with Lamictal is to delay the time to occurrence of mood episodes (depression, mania, hypomania, mixed episodes) in patients treated for acute mood episodes with standard therapy." Patients using valproate or other medications in concert with Lamictal need to be carefully monitored to achieve safe and effective medication interaction.
Lamictal is usually administered in chewable or oral-disintegrating tablets, taken with or without food. As with any drugs, if you are switching to Lamictal from another medication, carefully follow your doctor's instructions about timing and dosage.
Lamictal and Women Taking Oral Contraceptives
Be sure to tell your psychiatrist if you are a woman using estrogen-containing oral contraceptives. Your dosage of Lamictal will likely need to be increased to achieve maintenance of bipolar symptoms. Similarly, consult with your psychiatrist before either starting or discontinuing oral contraceptives if you take Lamictal so that she can re-evaluate and possibly adjust your dosage.
Why Take Lamictal?
Lamictal is one of many medications that treat Bipolar Disorder. Your psychiatrist will help you decide which medication(s) to choose, and it may take some time to find the right medication, dosage and/or combination of medications. Many look to Lamictal because of its strong benefit on depressive symptoms. It also seems to be especially beneficial for rapid cycling bipolar disorder (mood fluctuations that occur in rapid succession). Additionally, unlike some other bipolar treatments, Lamictal does not seem to lead to weight gain.
