Lamotrigine 

Overview

The most well-known use of lamotrigine is as an anticonvulsant, a drug used to treat epilepsy. When patients are given Lamotrigine, this may cause some confusion for them and their family without a prior seizure history. First authorized by the U.S. Food and Drug Administration (FDA), Lamotrigine   for the treatment of epilepsy, and it was subsequently authorized for the treatment of acute bipolar manic episode disarray. The term “labeled use” refers to the administration of a drug for its authorized uses. In the context of clinical practice, Nevertheless, doctors often recommend drugs for unapproved (or “off-label”) purposes when published clinical trials, case reports or their own clinical experiences attest to the therapy’ effectiveness and safety. Unlabeled applications of Lamotrigine   are used to treat treatment-resistant depression, cyclothymia, a milder type of bipolar illness, borderline personality disorder, and schizoaffective disorder, among others. When use Lamotrigine   for It is regarded as a mood stabilizer to treat mood disorders.

Lamotrigine   is useful in treating bipolar disorder that cycles quickly and depression, according to clinical research. particularly in those who did not respond to lithium at all or just partially. One may take Lamotrigine   on its own or used with another antidepressant, such lithium. However, when used with Depakote, there are steps that need to be taken to reduce the possibility of getting a potentially serious rash (see “Adverse Events and Safety Measures.” Lamotrigine   may be particularly useful in treating those who are “rapid cyclers, defined as those who have four or more manic or severe depression episodes year. In patients, mania is associated with agitation as opposed to euphoria may find Lamotrigine   beneficial. Additionally, Lamotrigine   could be very efficient in preventing or treating bipolar disorder. Individuals undergoing just Lamotrigine   therapy for Depressive symptoms were improved in bipolar depression.

Information about Dosing

Lamotrigine   is often begun at a low dose of 25 mg per day and raised by 25–50 mg over time every two weeks. The majority of individuals are taking 100–200 mg per day by week six. Whenever used in conjunction with Depakote (or soon after stopping the drug), it should be
even more gradually (for example, 25 mg every other day for the first two weeks), and the intended dose should not more than 100 mg daily. Conversely, when Tegretol (carbamazepine) is used with Lamotrigine, Tegretol speeds up its metabolism, hence a greater Lamotrigine   dose may be necessary.

Typical Side Effects

The most frequent adverse effects of Lamotrigine   are rash, headache, dizziness, sleeplessness, and impaired coordination, ataxia, or trouble walking, and gastrointestinal symptoms including nausea and vomiting and cramping in the abdomen. About 10% of those who use Lamotrigine   will get a rash, however there is a chance that substantially rise if Lamotrigine   is taken too quickly, in conjunction with Depakote, or various derivatives of valproate. More worrisome is the infrequent occurrence when the patient taking Lamotrigine   begins as a rash and escalates into potentially fatal systemic symptoms (see “Adverse Reactions and Precautions”).

Adverse Events and Safety Measures

Lamotrigine   might make you sleepy and make you less aware, particularly when you first start taking it. Patients need caution When operating a vehicle or carrying out activities requiring attentiveness.
Owing to the potential for severe rashes connected to Lamotrigine, the FDA mandated that the manufacturer provide a “black box” warning on the packaging. Approximately 1 in 1,000 patients have the possibility of experiencing a severe skin response among adults, but among children under the age of sixteen in 1 out of every 100 cases. Rashes, such as Stevens-Johnson syndrome, which is characterized by excruciating burning of the mucous membranes, skin, and is often lethal. The skin response depends on each person’s susceptibility, and aside from age, no other characteristic can determine a person’s vulnerability to a rash or its intensity. As soon as a rash appears, patients should cease using Lamotrigine; If they have a fever, sore throat, and malaise, they should go to the emergency room very away.

Utilization during pregnancy and nursing: Category C
Insufficient controlled research has been conducted on Lamotrigine   in pregnant women to assess the medication’s potential risks to the fetus and the mother. Nevertheless, research on animals indicates that Lamotrigine   could pose a concern as it has been shown to lower rats’ levels of the B vitamin folic acid. Reduced amounts in the fetus of folic acid are known to be detrimental to both humans and animals. Lamotrigine   use need to be avoided.

whenever feasible during pregnancy, but particularly in the first trimester. But if Lamotrigine   is necessary because the mother and unborn child are more at risk of relapse if the treatment is stopped.  After providing the doctor with informed permission, the patient has two options: either continue taking Lamotrigine   or find a substitute. Lamotrigine   should not be used by nursing women as it may affect the unborn child and is excreted in breast milk when consumed by a newborn. Breastfeeding should not begin if quitting the medication is not an option, or should be stopped.

Potential Interactions with Drugs

Combining Lamotrigine   with another drug may change how it is metabolized, which might have an impact on the Lamotrigine   or other medication’s blood levels. If the other medication’s level is noticeably diminished, the patient’s ability to respond to that drug might be jeopardized. Should the level be noticeably elevated When a person is more vulnerable to the harmful effects of the other drug. 

• Alcohol consumption should be avoided by Lamotrigine   patients since the combination may exacerbate sedation and fatigue. Additionally, alcohol’s sedative properties may have a depressive impact, masking its therapeutic benefits of Lamotrigine   and making therapy more difficult.
• When Tegretol (carbamazepine) is given together with Lamotrigine, Tegretol may cause the blood levels of Lamotrigine   to be greatly diminished. In these circumstances, the recommended dose increase for Lamotrigine   is 300–400 mg daily.  
• Valproic acid and Depakote (divalproex) together Other valproic acid formulations, such as Depakote, may raise Lamotrigine   levels significantly, which may raise the possibility of getting a rash. In these circumstances, Lamotrigine   should be administered gradually and generally speaking, the maximum daily dose shouldn’t over 100 mg daily.  
• Phenobarbital, Mysoline and Dilantin are drugs that, when used with Lamotrigine, cause convulsions could lower the amount in its blood. In these circumstances, a larger Lamotrigine   dose could be required.  
• Oral contraceptive estrogens and hormone substitutes (like Premarin), Lamotrigine   blood levels may be considerably decreased with the administration of the drug with estrogens or estrogen-containing oral contraceptives, decreasing Lamotrigine ‘s efficacy.
   

Overdosing

A Lamotrigine   overdose might be dangerous depending on how much is consumed. symptoms that are not life-threatening symptoms of an overdose include headache, somnolence, ataxia (reduced coordination while walking), and dizziness. In extreme situations, an overdose may cause psychosis, liver and kidney failure, a severe rash, and even a coma. In young children Compared to an adult of typical size, the fatal dose could be lower.

Treating any suspected overdose as an emergency is imperative. The individual has to be brought to the emergency space for care and observation. The prescription drug container (as well as any other medication suspected in the overdose) need to be brought up as well, as the details on the medication label may be useful in helping the treating physician figure out how many tablets the patient has taken.

Precaution Points to Remember

• If you forget to take a dosage, catch up by taking it two to three hours later than planned. If it’s near, Skip the missed dosage and resume your usual dosing regimen for the next scheduled dose. Never take double dosages.
• Take Lamotrigine   with food or right after meals to lessen unpleasant stomach.
• If you have a rash, call your doctor right away.
• Lamotrigine   may make you drowsy and sedentary, particularly first starting treatment, and it may also make you less attentive When driving or doing other duties that call for attentiveness, proceed with care.
• Keep the medicine out of direct sunlight and dampness, in the light-resistant container that came with it. Warmth and moisture may hasten the disintegration of your drug, causing it to lose its medicinal consequences.
• Keep your medicine out of children’s reach since it may be very harmful for young children to overdose.