A mother comforting her upset daughter

Your guide to medication Lamotrigine

Lamotrigine is a mood stabiliser used to treat depression in people with bipolar disorder.

Medication name: Lamotrigine ("la-MO-tri-jean")
Brand name: Lamictal ("la-MIC-tal")
Medication type: Mood stabiliser

Ways to take lamotrigine
Tablets: 25mg, 50mg, 100mg and 200mg strengths
Chewable/dispersible* tablets: 2mg, 5mg, 25mg and 100mg strengths

* These tablets dissolve in water or other liquid

What can it be used for?
If you are 18 or over, the doctor can prescribe lamotrigine for you as a licensed medicine to treat the low mood (depression) part of bipolar disorder. Lamotrigine is commonly used as a treatment for epilepsy, and you will see information about this in the leaflets about this medicine.

There is less research about its use and effectiveness in people under 18. Even so, specialists might prescribe it ‘off-label’ if they believe it is the best medicine for you.

Find out more about bipolar disorder

About lamotrigine

How lamotrigine works

Lamotrigine is a type of medicine called a ‘mood stabiliser’ as it can reduce feelings of excitability and over-activity and reduce mood swings. It tends to work better on the low mood (depression) part of bipolar disorder.

It is also taken by some people who have epilepsy, as it increases the effects of the calming transmitter GABA, leading to a reduction in seizures. This is a very separate use but will be covered in any patient leaflets.

Bipolar disorder

Lamotrigine and everyday life

Frequently asked questions

You may start off at a low dose and gradually increase it every few days or weeks until you and your doctor find the dose that is right for you. It may take up to six weeks to do this, by which time you should be a on a stable, long-term dose and have seen some helpful results from the medication.

It is important not to hurry the dosing timetable as doing so can increase your chances of getting a serious skin reaction.

You may want to let your family and friends know you are taking lamotrigine so they can support you and help you look out for side effects.

For guidance on this, check out our page on getting support with your medication.

Lamotrigine may make you feel very drowsy or sleepy when you start taking it.

It may also make it difficult for you to get to sleep.

If these symptoms carry on for a long time, or if this is difficult for you, talk to your doctor or pharmacist about other medicines you could take.

Alcohol

You can drink alcohol while taking lamotrigine, but it is likely to make you feel sleepier.

Street drugs

We do not know how street drugs affect lamotrigine, but all these drugs affect the way the brain works so they may not mix well.

Lamotrigine can produce a false positive test for phencyclidine (PCP) on a urine drug screen. Talk to your doctor about this if it is a problem for you.

Lamotrigine does not mix well with some other medicines and drugs and may affect the way in which they work. Tell your doctor if you are taking any other medications including over-the-counter medicines for common illnesses and things you put on your skin.

Special information about contraceptive pills containing oestrogen

  • When lamotrigine is taken with any type of the Pill (oral contraceptive) containing oestrogen, it lowers the level of lamotrigine that you have in your body.
  • If you have a pill-free week, the levels of lamotrigine will then rise, which may give you side effects.
  • If you take the Pill without a break, it will make your lamotrigine levels stable. You will not be harmed by not having the break.
  • Talk to your doctor or pharmacist before you start taking lamotrigine if you also take the Pill.
  • The morning-after pill does not affect the level of lamotrigine in your body as it does not contain oestrogen.

If you have any further questions about this, you should speak to your doctor or pharmacist.

Lamotrigine tablets have lactose in them which may not suit people who have a problem drinking milk or eating certain sugars. Talk to your doctor or pharmacist about this if you think it could be a problem for you.

Do not drive a car or ride a bike just after you start taking lamotrigine.

Taking lamotrigine may make you feel dizzy and may affect your eyesight when you start taking it (possibly causing blurred or double vision).

This could affect you if you drive a car, ride a bike, or do anything else that needs a lot of focus. It might be best to stop doing these things for the first few days, until you know how it affects you.

Do not worry - most people do these things as normal while taking lamotrigine.

Pregnancy

If you become pregnant while you are on lamotrigine, you should carry on taking the medicine and go back to your doctor as soon as possible to discuss whether you should stop or change your medicine.

Studies of over 7,500 women taking lamotrigine showed no increase in problems during the early stages of pregnancy.

Your doctor might also give you extra folic acid to take, which helps prevent any spine problems in your baby.

From month four onwards, you are likely to need a higher dose of lamotrigine to keep the level of the medication in your body constant. After giving birth, your lamotrigine dose will go back to what it was before.

If you are taking lamotrigine for epilepsy, any dose increases may be made based on the results of your blood level tests.

Post-natal

If you and your doctor agree that you will carry on taking lamotrigine throughout your pregnancy, you should tell your midwife that you are taking it before you give birth.

Breastfeeding

Lamotrigine can be passed to the baby in breastmilk, and side effects have been seen in breastfed babies. Usually there is no problem with breastfeeding a healthy baby.

Talk to your midwife or doctor about the benefits and risks of breastfeeding while taking lamotrigine.

There is nothing to suggest that lamotrigine has any effects on fertility.

Lamotrigine is not a banned substance in sport.

It could, however, make you feel dizzy and give you blurred or double vision when you start taking it.

It might be better to delay any sport that needs a lot of focus until you know how it affects you.

Do not worry - most people play sports as normal while taking lamotrigine.

Try not to take lamotrigine for the first time just before your exams, as you may have sleep problems (feeling tired or having difficulty getting to sleep), and some blurred eyesight or double vision when you start taking lamotrigine.

You should talk to your doctor about any future exams if you are starting lamotrigine.

You might decide together to delay starting it until you have done them.

If they are more than a month away, however, you might find that it is better to start lamotrigine to improve your motivation to study.

Do not worry - most people do all these things as normal while taking lamotrigine.

Your doctor should know

  • You need to talk to your doctor or pharmacist before starting treatment with lamotrigine if any of the following apply to you:

    • you have kidney problems
    • you develop rashes after taking lamotrigine or any other medicines for bipolar disorder or depression
    • you have or develop a blood condition called HLH. It produces symptoms like fever, headache, feeling or being sick, stiff neck or your eyes being sensitive to bright light. It is also a very rare side effect of taking lamotrigine

    Lamotrigine tablets have lactose in them which may not suit people who have a problem drinking milk or eating certain sugars. Talk to your doctor or pharmacist about this if you think it could be a problem for you.

Uses, warnings, safety and side effects

Taking lamotrigine

How long will I need to take lamotrigine for?

You and your doctor should talk about how long you need to take lamotrigine before you begin treatment with this medication.

If you take lamotrigine for bipolar disorder you will probably take it for at least six months (any shorter and your old symptoms can come back). If it works for you, you may take it for much longer than that.

You should only take lamotrigine as agreed with your doctor

Make sure that you know your dose. If it is not written on the label, check with your pharmacist or doctor.

You may have to take lamotrigine once or twice a day.

It doesn’t matter what time you take it each day – choose a time that you can always remember. This could be at mealtimes, or when you brush your teeth. You can take it before or after food.

If you are taking the tablets that you swallow whole, wash them down with a glass of water. Do not try and chew them – they will taste unpleasant.

If you are taking the orodispersible tablets (melts), get a glass of cold water and mix the tablet(s) in at least enough water to cover them. You can stir the drink to help them break up. 'Dispersible' doesn’t mean you will get a totally clear solution - it will look a little cloudy. Drink it all, and then add more water to the glass and drink that in order to make sure you get all the medicine in the tablet.

You can also chew the dispersible tablets, but it may help to rinse them down with some cold water.

You can still swallow the dispersible tablets whole with water if you prefer.

What if I miss a dose?

If you remember later during the day, take it as soon as possible. If you forget to take it by the time of the next dose, just start again with the next dose.

Do not take a double dose.

What will happen if I forget to take my lamotrigine?

If you forget to take your tablets for a few days, you may start getting your old symptoms of low mood back.

Stopping the use of lamotrigine

Although you may not be taking your lamotrigine for seizures (fits), if you stop the medication suddenly, there is a chance you may have a seizure. This is because after taking lamotrigine for some time, your body will have got used to having an anticonvulsant (anti-seizure) medicine on board. Suddenly stopping the use of lamotrigine may therefore cause a seizure. But don't worry - this doesn't mean you are suddenly epileptic.

If you have stopped taking lamotrigine, you need to speak to your doctor so that you can safely start it again and build back up to your dose. It is best to be honest; they will help you get back on track.

If you are thinking of stopping treatment with lamotrigine, talk to your doctor before doing this.

Warnings and safety

Safety headlines

If you have taken more lamotrigine than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different.

While taking lamotrigine, some people may think about hurting themselves or taking their own lives. You must go straight to hospital with your medicine if you have any of these thoughts.

Lamotrigine can cause other serious side effects: allergic reactions (difficulty breathing, swelling of your face or throat, itching skin lumps), skin rashes and other serious symptoms. Go to a hospital with your medicine if you get any of these symptoms.

Lamotrigine does not mix well with some other medicines and drugs. The contraceptive Pill can affect the level of lamotrigine in your blood. Talk to your doctor about this if you are on the Pill.

You might feel dizzy or have double vision in the first few days after taking lamotrigine. Do not drive a car, ride a bike or operate machines until you see how this affects you.

Use good contraception while you are taking lamotrigine. If you take it while you are pregnant, it is unlikely to affect the developing baby. However, it can cause symptoms in babies if you breastfeed while taking lamotrigine. Talk to your doctor or midwife about this and get their help.

When to go to the hospital

If you have taken more lamotrigine than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different. Go to A&E, and take your medicine with you to show the doctors. Tell them how much you have taken. Get a friend to go with you, if you can, just in case you feel ill on the way.

You might get any of the following symptoms:

  • quick, uncontrollable body movements
  • clumsiness and lack of co-ordination, causing problems with your balance
  • heart rhythm changes
  • loss of consciousness, convulsions/seizures (fits) or coma

While taking lamotrigine some people may think about hurting themselves or have thoughts of taking their own lives. This can happen to anyone, including people who are under 25. These thoughts may happen or get worse in the first few weeks of taking the medicine. You must go straight to hospital with your medicine if you have any of these thoughts and tell the doctor that you are taking lamotrigine. There are other medications you can take instead.

You should also go to a doctor or hospital straight away if you get any of the following symptoms:

  • skin rashes or redness with blisters and peeling skin around the mouth, nose, eyes and groin/sex organs (genitals)
  • peeling of large areas of skin (up to 30% - almost a third – of your body surface)
  • ulcers in the mouth, throat, nose or around your groin/sex organs (genitals)
  • red or swollen eyes
  • a high temperature (fever), flu-like symptoms or drowsiness
  • swelling around your face
  • swollen glands in your neck, armpit or groin
  • unexpected bleeding or bruising
  • your fingers turning blue
  • a sore throat
  • more infections (such as colds) than usual

If these reactions occur, they tend to be during the first eight weeks of taking lamotrigine.

Side effects

Side effects

Some side effects that appear should get better after a few days. If they do not, you should go back to your doctor.

Do not stop taking the tablets until you talk to your doctor, or you may get withdrawal symptoms as well.

Very common side effects of taking lamotrigine (affecting more than one in ten people) include:

  • headaches
  • skin rashes

Common side effects of taking lamotrigine (affecting up to one in ten people) include:

  • feeling aggressive, agitated or irritable
  • feeling sleepy, tired or drowsy
  • insomnia (having difficulty sleeping)
  • feeling dizzy
  • shaking or tremors
  • diarrhoea (loose poo)
  • dry mouth
  • nausea (feeling sick) or vomiting (being sick)
  • having pain in your back or joints, or elsewhere

There are other side effects that you can get when taking this medicine; we have only included the most common ones here.

Please look at the leaflet inside your medicine box, or ask a doctor or pharmacist, if you want to know whether you are getting a side effect from your medicine.

If you do get a side effect, please think about reporting it via the Yellow Card Scheme.

Taking lamotrigine

How long will I need to take lamotrigine for?

You and your doctor should talk about how long you need to take lamotrigine before you begin treatment with this medication.

If you take lamotrigine for bipolar disorder you will probably take it for at least six months (any shorter and your old symptoms can come back). If it works for you, you may take it for much longer than that.

You should only take lamotrigine as agreed with your doctor

Make sure that you know your dose. If it is not written on the label, check with your pharmacist or doctor.

You may have to take lamotrigine once or twice a day.

It doesn’t matter what time you take it each day – choose a time that you can always remember. This could be at mealtimes, or when you brush your teeth. You can take it before or after food.

If you are taking the tablets that you swallow whole, wash them down with a glass of water. Do not try and chew them – they will taste unpleasant.

If you are taking the orodispersible tablets (melts), get a glass of cold water and mix the tablet(s) in at least enough water to cover them. You can stir the drink to help them break up. 'Dispersible' doesn’t mean you will get a totally clear solution - it will look a little cloudy. Drink it all, and then add more water to the glass and drink that in order to make sure you get all the medicine in the tablet.

You can also chew the dispersible tablets, but it may help to rinse them down with some cold water.

You can still swallow the dispersible tablets whole with water if you prefer.

What if I miss a dose?

If you remember later during the day, take it as soon as possible. If you forget to take it by the time of the next dose, just start again with the next dose.

Do not take a double dose.

What will happen if I forget to take my lamotrigine?

If you forget to take your tablets for a few days, you may start getting your old symptoms of low mood back.

Stopping the use of lamotrigine

Although you may not be taking your lamotrigine for seizures (fits), if you stop the medication suddenly, there is a chance you may have a seizure. This is because after taking lamotrigine for some time, your body will have got used to having an anticonvulsant (anti-seizure) medicine on board. Suddenly stopping the use of lamotrigine may therefore cause a seizure. But don't worry - this doesn't mean you are suddenly epileptic.

If you have stopped taking lamotrigine, you need to speak to your doctor so that you can safely start it again and build back up to your dose. It is best to be honest; they will help you get back on track.

If you are thinking of stopping treatment with lamotrigine, talk to your doctor before doing this.

Warnings and safety

Safety headlines

If you have taken more lamotrigine than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different.

While taking lamotrigine, some people may think about hurting themselves or taking their own lives. You must go straight to hospital with your medicine if you have any of these thoughts.

Lamotrigine can cause other serious side effects: allergic reactions (difficulty breathing, swelling of your face or throat, itching skin lumps), skin rashes and other serious symptoms. Go to a hospital with your medicine if you get any of these symptoms.

Lamotrigine does not mix well with some other medicines and drugs. The contraceptive Pill can affect the level of lamotrigine in your blood. Talk to your doctor about this if you are on the Pill.

You might feel dizzy or have double vision in the first few days after taking lamotrigine. Do not drive a car, ride a bike or operate machines until you see how this affects you.

Use good contraception while you are taking lamotrigine. If you take it while you are pregnant, it is unlikely to affect the developing baby. However, it can cause symptoms in babies if you breastfeed while taking lamotrigine. Talk to your doctor or midwife about this and get their help.

When to go to the hospital

If you have taken more lamotrigine than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different. Go to A&E, and take your medicine with you to show the doctors. Tell them how much you have taken. Get a friend to go with you, if you can, just in case you feel ill on the way.

You might get any of the following symptoms:

  • quick, uncontrollable body movements
  • clumsiness and lack of co-ordination, causing problems with your balance
  • heart rhythm changes
  • loss of consciousness, convulsions/seizures (fits) or coma

While taking lamotrigine some people may think about hurting themselves or have thoughts of taking their own lives. This can happen to anyone, including people who are under 25. These thoughts may happen or get worse in the first few weeks of taking the medicine. You must go straight to hospital with your medicine if you have any of these thoughts and tell the doctor that you are taking lamotrigine. There are other medications you can take instead.

You should also go to a doctor or hospital straight away if you get any of the following symptoms:

  • skin rashes or redness with blisters and peeling skin around the mouth, nose, eyes and groin/sex organs (genitals)
  • peeling of large areas of skin (up to 30% - almost a third – of your body surface)
  • ulcers in the mouth, throat, nose or around your groin/sex organs (genitals)
  • red or swollen eyes
  • a high temperature (fever), flu-like symptoms or drowsiness
  • swelling around your face
  • swollen glands in your neck, armpit or groin
  • unexpected bleeding or bruising
  • your fingers turning blue
  • a sore throat
  • more infections (such as colds) than usual

If these reactions occur, they tend to be during the first eight weeks of taking lamotrigine.

Side effects

Side effects

Some side effects that appear should get better after a few days. If they do not, you should go back to your doctor.

Do not stop taking the tablets until you talk to your doctor, or you may get withdrawal symptoms as well.

Very common side effects of taking lamotrigine (affecting more than one in ten people) include:

  • headaches
  • skin rashes

Common side effects of taking lamotrigine (affecting up to one in ten people) include:

  • feeling aggressive, agitated or irritable
  • feeling sleepy, tired or drowsy
  • insomnia (having difficulty sleeping)
  • feeling dizzy
  • shaking or tremors
  • diarrhoea (loose poo)
  • dry mouth
  • nausea (feeling sick) or vomiting (being sick)
  • having pain in your back or joints, or elsewhere

There are other side effects that you can get when taking this medicine; we have only included the most common ones here.

Please look at the leaflet inside your medicine box, or ask a doctor or pharmacist, if you want to know whether you are getting a side effect from your medicine.

If you do get a side effect, please think about reporting it via the Yellow Card Scheme.

About this information

The information on this page was reviewed by the College of Mental Health Pharmacy in March 2020.

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