Lamotrigine Uses

Lamotrigine is used to treat primary generalized tonic-clonic seizures and partial seizures (also called partial onset seizures, focal seizures, or focal onset aware seizures). It is also prescribed to people with Lennox-Gastaut syndrome, a condition associated with seizures and developmental delay. Additionally, lamotrigine is used for treating acute bipolar depression and mania, where it can help prolong the time between acute mood episodes.

There may be other uses of lamotrigine—your pharmacist or doctor can give you further drug information.

Lamotrigine Mechanism of Action

Lamotrigine decreases abnormal brain activity by inhibiting voltage-sensitive sodium channels and stabilizing neuronal membranes in the central nervous system (brain and spinal cord).

Lamotrigine Doses

Lamotrigine is available as tablets (25 mg, 100 mg, 150 mg, and 200 mg), extended release tablets (25 mg, 50 mg, 100 mg, 200 mg, 250 mg, and 300 mg), chewable dispersible tablets (2 mg, 5 mg, and 25 mg), and orally disintegrating tablets (25 mg, 50 mg, 100 mg, and 200 mg).

The lamotrigine dose depends on the condition being treated, other drugs the patient is taking, and the patient’s age. Typical doses are as follows:

For epilepsy: A starting dose ranging from 25 mg every other day to 50 mg once a day. The maintenance dose for immediate release lamotrigine usually ranges from 100 mg to 500 mg daily taken in 1-2 doses. The maintenance dose of the extended release form is usually between 200 mg and 600 mg once a day in adults. The dose in children depends on the child’s body weight. 

For bipolar disorder: A starting dose ranging from 25 mg every other day to 50 mg once a day. The maintenance dose usually ranges from 100 mg to 200 mg twice a day.

Note: Taking lamotrigine is associated with an increased risk of a life-threatening skin rash. For this reason, your doctor will give you a low initial dose and slowly increase your dose over several weeks. There are Lamictal starter kits and ODT patient titration kits available to help you take the medicine correctly without exceeding the recommended dose in the first 5 weeks of treatment.

You should not restart lamotrigine if you have had a severe skin reaction on this medicine in the past unless your doctor decides that the potential benefits outweigh the risks.

The maintenance dose of lamotrigine will need to be adjusted if you start or stop estrogen-containing birth control pills.

If you are coming off lamotrigine, do not stop taking the medicine suddenly. Your doctor will tell you how to discontinue the medicine gradually, over a period of at least 2 weeks, and by reducing the dose by no more than half every week.