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"What is&amp;amp;nbsp;Lamictal used for?  Epilepsy. Lamotrigine is used to treat generalised tonic-clonic seizures (grand mal epilepsy) and partial seizures, as well as absence seizures in children. Type of severe childhood epilepsy (Lennox-Gastaut syndrome). Preventing depressive episodes in people with bipolar affective disorder who experience mostly depressive epidoses.  How does&amp;amp;nbsp;Lamictal work? Lamictal&amp;amp;nbsp;contains the active ingredient lamotrigine, which is a medicine used to treat epilepsy.&amp;amp;nbsp;Lamotrigine works by stabilising electrical activity in the brain. The brain and nerves are made up of many nerve cells that communicate with each other through electrical signals. These signals must be carefully regulated for the brain and nerves to function properly. When abnormally rapid and repetitive electrical signals are released in the brain, the brain becomes over-stimulated and normal function is disturbed. This results in fits or 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. A build up of sodium in the nerve cells is necessary for the electrical signal to build up and be passed on to other nerve cells. As lamotrigine prevents this, it helps stabilise the electrical activity in the brain. Preventing the build-up of the electrical signal also prevents the release of a neurotransmitter called glutamate from the nerve cells in the brain. Neurotransmitters are chemicals that are stored in nerve cells and are involved in transmitting messages between the nerve cells. Glutamate is a neurotransmitter that acts as a natural &amp;#039;nerve-exciting&amp;#039; agent. It is released when electrical signals build up in nerve cells and subsequently excites more nerve cells. It is thought to play a key role in causing epileptic seizures. Reducing the release of glutamate from the nerve cells in the brain is another way in which lamotrigine helps stabilise the electrical activity in the brain and prevent epileptic fits.  In addition to its use for treating epilepsy, lamotrigine is used by specialists as a mood stabiliser for treating people with the psychiatric illness, bipolar affective disorder. Lamotrigine is used to help prevent episodes of depression in people who suffer mostly from this side of the illness. It is not fully understood how lamotrigine works in this illness, but is thought to be to do with the reduction of glutamate in the brain. Lamictal tablets should be swallowed whole with a drink of water. Lamictal dispersible tablets may be chewed, dispersed in a small volume of water (at least enough to cover the whole tablet) or swallowed whole with a little water. Important information about&amp;amp;nbsp;Lamictal  Adverse skin reactions have been reported with lamotrigine. These reactions are usually mild and get better on their own, but can on rare occasions be more serious and potentially life-threatening. The risk is higher in children under 12 years of age and in people who are also taking the medicine valproate. When starting treatment with lamotrigine the dose is increased gradually to minimise the risk of developing a skin rash. For this reason it is very important to follow the instructions you are given with this medicine, and not to exceed the prescribed dose. If you or your child develop a rash, fever, facial swelling or swollen glands while taking this medicine you should consult your doctor immediately. If the doctor decides the reaction is related to this medicine you will need to stop taking it. You should not stop taking this medicine suddenly unless your doctor tells you to, as this may result in your seizures returning or getting worse. If it is decided that you should stop taking this medicine, it should be withdrawn gradually, following the instructions given by your doctor. If for any reason you stop treatment for longer than five days and then restart, your doctor may want you to increase your dose gradually, as when you first started the medicine, to minimise the risk of getting a skin reaction. If you have epilepsy it is important to take your medication regularly, as directed by your doctor, because missing doses can trigger seizures in some people. If you have trouble remembering to take your medicine you should ask your pharmacist for advice. You may find a pill reminder box helpful. This medicine may cause dizziness and double vision. As a result it could reduce your ability to drive or operate machinery safely. You should discuss this with your doctor. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won&amp;#039;t affect your performance. This medicine may rarely cause a decrease in the normal amounts of blood cells in the blood. For this reason you should consult your doctor immediately if you experience any of the following symptoms: unexplained bruising or bleeding, purple spots, sore throat, mouth ulcers, high temperature (fever), feeling tired or general illness. Your doctor may want to take a blood test to check your blood cells. There may be a small increased risk of suicidal thoughts and behaviour in people taking antiepileptic medicines such as lamotrigine for any indication. For this reason, it is very important to seek medical advice if you, or someone else taking this medicine, experience any changes in mood, distressing thoughts, or feelings about suicide or self-harm at any point while taking this medicine. For more information speak to your doctor or pharmacist.  Lamictal should be used with caution in  Elderly people. Decreased liver function. Kidney failure. Parkinson&amp;#039;s disease. History of allergic reactions or rash due to other antiepileptic medicines.  Lamictal should not be used in  The safety and effectiveness of this medicine in children under two years of age have not been established by the manufacturer.   This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately. Pregnancy and breastfeeding Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.  It is vital that women with epilepsy receive specialist advice before getting pregnant, so they are well informed of potential risks and benefits of continuing antiepileptic treatment during pregnancy. Pregnant women taking antiepileptic medicine have a higher risk of carrying a baby with developmental problems and malformations. However, if a woman with epilepsy stops treatment because she is pregnant, there is a risk of seizures that can harm both mother and baby.  If you decide to try for a baby while taking lamotrigine you should seek medical advice from your doctor as soon as possible. It may be recommended that you start taking folic acid 5mg daily as soon as contraception is stopped, as this may reduce the risk of neural tube defects such as spina bifida in the baby.  Women who continue to take lamotrigine during a pregnancy should, wherever possible, be prescribed lamotrigine on its own, in the lowest effective dose. Your doctor may need to adjust your lamotrigine dose from time to time, because changes to your body during pregnancy may affect the amount of lamotrigine in your blood and its effectiveness.  Lamotrigine passes into breast milk. Mothers who need to take lamotrigine should discuss the pros and cons of breastfeeding with their doctor. You should only breastfeed if the potential benefits of breastfeeding are considered to be greater than the risk of side effects from the medicine on the nursing infant. Seek medical advice from your doctor.  Possible side effects of Lamictal Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.  Skin rashes. Headache. Drowsiness. Dizziness. Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain. Pain in the joints or back pain. Difficulty in sleeping (insomnia). Visual disturbances, such as double vision or blurred vision. Shaking, usually of the hands (tremor). Confusion. Agitation. Irritability. Aggression. Hallucinations. Disturbances in the numbers of blood cells in the blood. Shaky movements and unsteady walk (ataxia). Severe blistering skin reaction affecting the tissues of the eyes, mouth, throat and genitals (Stevens-Johnson Syndrome). Disturbances of liver function.  The side effects listed above may not include all of the side effects reported by the medicine&amp;#039;s manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist. If you think you have experienced a side effect from a medicine or vaccine you should check the patient information leaflet. This lists the known side effects and what to do if you get them. You can also get advice from your doctor, nurse or pharmacist. If they think it&amp;#039;s necessary they&amp;#039;ll report it for you. You can also report side effects yourself using the yellow card website: www.mhra.gov.uk/yellowcard. How can Lamictal affect other medicines? It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.  Valproate (as sodium valproate, valproate semisodium or valproic acid) increases the blood level of lamotrigine. If you are taking a valproate medicine when you start treatment with lamotrigine, your starting dose of lamotrigine will be increased more gradually than normal. You should carefully follow the instructions given to you by your doctor or pharmacist. Hormonal contraceptives (eg the pill) can reduce the amount of lamotrigine in the blood and make it less effective at controlling seizures. In addition, lamotrigine can make the pill less effective at preventing pregnancy. For this reason, women taking lamotrigine who need a contraceptive should preferably use a non-hormonal method such as condoms. When you start taking lamotrigine your doctor will review your contraception and advise on methods that are safe and effective for you to use. A hormonal contraceptive should only be used as the sole method of contraception if there is no other alternative. If the pill is chosen as your only method of contraception, you must tell your doctor if you experience changes in your menstrual pattern (eg bleeding between periods), as this may indicate that your pill is becoming less effective at preventing pregnancy. It is also important to tell your doctor if you plan to start or stop using hormonal contraceptives such as the pill while taking lamotrigine, as your lamotrigine dose may need re-adjusting. The use of hormone replacement therapy (HRT) in combination with lamotrigine has not been studied, but it may interact in a similar way to hormonal contraceptives, by reducing the amount of lamotrigine in the blood and making it less effective at controlling seizures. The following medicines may also reduce the blood level of lamotrigine:  carbamazepine phenobarbital phenytoin primidone rifampicin.  If you are taking any of these medicines with lamotrigine your doctor may need to increase your lamotrigine dose. It is recommended that people who are taking any antiepileptic medicines should avoid taking the herbal remedy St John&amp;#039;s wort (Hypericum perforatum). This is because St John&amp;#039;s wort may affect the level of antiepileptic medicines in the blood and could increase the risk of seizures.  There may be an increased chance of side effects such as headache, dizziness, blurred vision, double vision, sleepiness and nausea if carbamazepine or oxcarbazepine are taken with lamotrigine. If this occurs your doctor may need to reduce the dose of the carbamazepine or oxcarbazepine. Other medicines containing the same active ingredient Lamotrigine tablets and dispersible tablets are also available without a brand name, ie as the generic medicine. Care should be taken if switching between lamotrigine tablets and dispersible tablets, or between generic lamotrigine products made by different manufacturers. This is because lamotrigine in different forms or made by different manufacturers may potentially differ in the way it is absorbed into the body, which could either reduce the effect of the medicine and increase the risk of seizures, or increase the effect of the medicine and increase the risk of side effects. You should check with your pharmacist if you are ever dispensed your lamotrigine in a different form or made by a different manufacturer. Further reading For background information about our medicine factsheets, including the references used to produce them, click here. Last updated 25.08.2008 "^^<http://www.w3.org/2001/XMLSchema#string>
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