Overview
Can Lamictal help as the way out of depression’s darkness? Originally designed to tackle seizures, this versatile medication has found a new place in the world of psychiatry and mood disorders, particularly depression. It is a mood stabilizer and thus helps people with bipolar disorders.
Lamictal, or lamotrigine, stands out from traditional antidepressants with its unique approach to lifting the veil of sadness. By tinkering with brain chemicals in a novel way, it offers hope to those struggling with treatment-resistant depression and bipolar disorder. Lamictal’s path is not without risks, including severe skin reactions that require careful monitoring.
So, is Lamictal the silver bullet for depression? While it shines brightly for some, its light may be dim for others. Consulting with an expert is the first step on this intriguing journey to illuminate the path to mental wellness. We’re sure you have many questions, and we’ve got the answers you need. In this blog, we will acquaint you with the usage of these medicines and essential information.
Can Lamictal be used for depression?
Yes, Lamictal (lamotrigine) can be used for depression, particularly in cases where standard antidepressants have not been effective. It is commonly used off-label for treating depression, especially in bipolar disorder. Lamictal is known for its mood-stabilizing properties and has been found to help alleviate depressive symptoms in some people. However, like all medications, it may not work for everyone and can have side effects.
“Lamotrigine’s modulation of neurochemical pathways offers promise in addressing the intricate neurobiology of depression, paving the way for targeted interventions in mood disorders,”
says Dr. Richard Honekar
How does Lamictal work in the brain for depression?
Lamictal, sometimes referred to as lamotrigine, works on particular neurotransmitters in the brain, which are chemicals that facilitate the transmission of information between nerve cells. Although Lamictal’s precise mode of action has yet to be entirely understood, it is thought to assist in controlling the amounts of neurotransmitters like glutamate and serotonin.
An excitatory neurotransmitter involved in memory and learning is glutamate. Glutamate release is known to be lowered by lamictal, which may help control mood and minimize depressive symptoms.
One neurotransmitter essential for controlling mood, hunger, and sleep is serotonin. Lamictal may raise serotonin levels in the brain, which lifts sadness and elevates mood.
Lamictal’s capacity to regulate these neurotransmitters adds to its efficacy.
Lamictal forms and strengths of Lamictal ( Lamotrigine)
The table below outlines the various forms of Lamictal and their corresponding strengths, including chewable tablets, orally disintegrating tablets, oral tablets, and extended-release oral tablets.
| Form | Strength |
|---|---|
| Lamotrigine Chewable Tablet | 2 mg, 5 mg, 25 mg |
| Lamotrigine Orally Disintegrating Tablet (ODT) | 25 mg, 50 mg, 100 mg, 200 mg |
| Lamotrigine Oral Tablet | 25 mg, 100 mg, 150 mg, 200 mg |
| Lamotrigine Extended-Release (XR) Oral Tablet | 25 mg, 50 mg, 100 mg, 200 mg, 250 mg, 300 mg |
Is there a typical dose of Lamotrigine?
Your doctor will usually start you on a low dosage. They will then gradually modify it to get the appropriate dose for you according to the follow-up response. Ultimately, your doctor will recommend the lowest dose necessary to get the intended result.
Lamictal interacts with several medications. The amount of Lamictal in your blood can change depending on your medications. This may impact the drug’s effectiveness or exacerbate any adverse effects. The dose of Lamictal you take depends on whether you already take any other medicine and whether they interact with Lamictal.
Three different dosing schedules are included in the prescribing material.
Situation 1: Consuming a medication that raises your blood levels of Lamictal, such as valproate medications like Depakote or Depakote XR (divalproex sodium).
Situation 2: Avoiding medications that may alter the blood levels of Lamictal
Situation 3: Using medication that lowers your blood levels of Lamictal, such as Dilantin (phenytoin), Tegretol (carbamazepine), phenobarbital, Mysoline (primidone), or Kaletra (lopinavir/ritonavir).
The regimens are explained below.
Lamotrigine antidepressant dosage for bipolar disorder
To treat bipolar illness, doctors may give chewable tablets, ODTs, or Lamictal tablets for oral suspension. Usually, this medicine is taken in addition to other bipolar disorder treatments.
The usual dosage plan, including the initial and maintenance dosages, is displayed in the table below. Your physician will determine the appropriate maintenance dosage for you.
| Situation | Weeks 1–2 | Weeks 3–4 | Weeks 5 | Week 6 | Week 7 and on |
|---|---|---|---|---|---|
| Situation 1: Consuming a medication that raises your Lamictal blood levels. | 25 mg every other day | 25 mg once per day | 50 mg once per day | 100 mg once per day | 100 mg once per day |
| Situation 2: Avoiding medications that may alter the blood levels of Lamictal | 25 mg once per day | 50 mg once per day | 100 mg once per day | 200 mg once per day | 200 mg once per day |
| Situation 3: Using medication that lowers your blood levels of Lamictal. | 50 mg once per day | 100 mg per day in divided doses | 200 mg per day in divided doses | 300 mg per day in divided doses | 400 mg per day in divided doses |
The maximum dosage for Dosage 3 is 400 mg daily in divided doses.
Lamictal therapy for bipolar illness may only be used temporarily. When taking Lamictal for longer than 16 weeks, your doctor will decide whether to keep you on the medication or not. Discuss with your doctor how long you plan to take Lamictal.
Consult your doctor if you need to begin or stop taking any other medicines for bipolar illness. They might have to change the dosage of Lamictal you take depending on what else you are taking.
Lamotrigine dosage for epilepsy
Adults and confident children with epilepsy are taking Lamictal. It is specifically prescribed to treat Lennox-Gastaut syndrome, partial-onset seizures, and generalized tonic-clonic seizures. Along with other anti-seizure medications, the medicine may be prescribed.
The following table lists the recommended dosages of Lamictal ODTs and chewable tablets for oral suspension in adults and children over twelve when combined with other prescriptions.
| Situation | Weeks 1–2 | Weeks 3–4 | Weeks 5 and on until maintenance dosage is reached | Maintenance dosage |
|---|---|---|---|---|
| Situation 1: Consuming a medication that raises your Lamictal blood levels. | 25 mg every other day | 25 mg once per day | daily dose increase by 25–50 mg every 1–2 weeks | 100–400 mg per day, taken in 1 or 2 divided doses |
| Situation 2: Avoiding medications that may alter the blood levels of Lamictal | 25 mg once per day | 50 mg once per day | daily dose increase by 50 mg every 1–2 weeks | 225–375 mg per day, taken in 2 divided doses |
| Situation 3: Using medication that lowers your blood levels of Lamictal. | 50 mg once per day | 50 mg twice per day | daily dose increase by 100 mg every 1–2 weeks | 300–500 mg per day, taken in 2 divided doses |
Discontinuation of lamotrigine therapy:
In chronic therapy, withdrawal is gradual to minimize the risk of increased seizure frequency and withdrawal symptoms such as dysphoria, hallucinations, headache, insomnia, and tremors unless safety concerns necessitate a faster withdrawal. In bipolar disorder trials, doses were tapered by 50% weekly over two weeks. For seizure disorders like with lamotrigine, withdrawal may span 2 to 6 months.
Restarting therapy after treatment interruption or discontinuation:
When restarting lamotrigine after ≥5 half-lives, the initial dose and escalation schedule are started. For interruptions <5 half-lives, a low dose and gradual titration are done. Prior daily dose and concomitant medications affecting lamotrigine’s half-life are considered. Do not resume if discontinued due to an allergic reaction.
Who can (and cannot) take lamotrigine for depression?
Lamotrigine (Lamictal) can be taken by adults and children for depression, particularly in cases where standard antidepressants have not been effective. It is also used for bipolar disorder and certain types of seizures.
However, certain groups of people should be cautious or avoid taking lamotrigine:
Allergy
If you are allergic to lamotrigine or its ingredients, you should not take it.
Skin Rash
Severe skin rashes, such as toxic epidermal necrolysis and Stevens-Johnson syndrome, can be brought on by lamotrigine. You should contact a doctor immediately if you experience a rash while taking lamotrigine, particularly if a fever or swollen glands accompany it.
Liver Problems
People with liver disease or a history of liver problems should use lamotrigine cautiously, as it can affect liver function.
Kidney Problems
Lamotrigine dosage adjustments or strict monitoring are necessary for people with renal disease or poor kidney function.
Pregnancy and Breastfeeding
Lamotrigine might not be safe to use while expecting, particularly during the first trimester. Breastfeeding while taking lamotrigine should be discussed with a healthcare provider as it can also enter into breast milk.
Other Medical Conditions
People with certain medical conditions, such as heart disease, should use lamotrigine with caution and under the supervision of a healthcare provider.
How long does lamotrigine take to start working for depression?
Lamotrigine (Lamictal) typically takes several weeks to start working for depression. It usually starts at a low dose and gradually increases to reach the effective dose.
For many people, it may take 4 to 6 weeks or longer to feel the full antidepressant effects of lamotrigine. However, some individuals may experience an earlier improvement in their symptoms.
How long is Lamictal typically prescribed for depression?
Lamotrigine is often prescribed as a long-term treatment for depression, particularly in cases where standard antidepressants have been ineffective or when there’s a risk of mood destabilization, such as in bipolar disorder. While treatment duration can vary depending on individual response and the severity of the depressive symptoms, it’s commonly recommended to continue lamotrigine therapy for at least six months to achieve optimal therapeutic effects. However, some individuals may benefit from taking it for a longer duration if it proves to be effective and well-tolerated to prevent the recurrence of depressive episodes. Ultimately, the duration of lamotrigine treatment for depression is determined through careful assessment by a doctor/psychiatrist, considering factors such as treatment response, side effects, and the overall management of the individual’s mental health condition.
Is it okay to stop taking lamotrigine suddenly?
Even though you might not be taking lamotrigine for fits or seizures, you run the risk of experiencing a seizure if you abruptly stop taking the drug. This is because your body will have been accustomed to having an anticonvulsant (anti-seizure) medication on board after taking lamotrigine for a while. Thus, abruptly quitting lamotrigine medication could result in seizures. However, this does not indicate that you had an epileptic seizure.
You should consult your physician if you have stopped taking lamotrigine to safely resume taking it and gradually increase your dosage. Being truthful is preferable since it will assist you in getting back on track.
When should I see a doctor?
If you’re experiencing symptoms of depression and considering treatment options like Lamictal (lamotrigine), it’s crucial to seek medical advice. Persistent sadness or low mood lasting more than two weeks, loss of interest in once-enjoyable activities, changes in appetite or weight, alterations in sleep patterns, fatigue, feelings of worthlessness or excessive guilt, difficulty concentrating, and thoughts of death or suicide are all signs that warrant a doctor’s evaluation. Consulting with a healthcare professional allows for proper assessment, diagnosis, and consideration of appropriate treatment options tailored to individual needs, ensuring effective management of depression and minimizing potential risks.
FAQs about Lamictal for depression
Lamotrigine crosses the placenta, but no overall increased risk for major congenital malformations has been observed in studies. However, the potential risk of cleft lip/palate remains uncertain. Larger doses may elevate malformation risks. Polytherapy heightens risks; monotherapy at the lowest effective dose is advised. Pregnant women may need lamotrigine dose adjustments due to physiological changes; monitoring during pregnancy is recommended, with baseline serum concentrations checked before pregnancy and continued monitoring throughout and after birth.
Yes, Lamictal (lamotrigine) can be used as a monotherapy for depression, but it is more commonly used in conjunction with other medications for this purpose. It is particularly effective for individuals with bipolar depression or treatment-resistant depression.
Using Lamictal without a proper diagnosis and prescription can lead to several risks. These include the potential for no therapeutic benefit, serious side effects such as skin rashes like Stevens-Johnson syndrome, interactions with other medications, masking of underlying mental health conditions delaying appropriate treatment, and the possibility of worsening mood symptoms or other adverse effects. It’s essential to use Lamictal only as prescribed by a qualified healthcare provider after proper evaluation and diagnosis.
Lamictal (lamotrigine) is primarily indicated for the treatment of bipolar disorder and epilepsy rather than anxiety disorders. While some individuals may experience a reduction in anxiety symptoms as a secondary effect of improved mood stabilization, Lamictal is not specifically approved by regulatory agencies for the treatment of anxiety disorders.
