What is Lamictal (Lamotrigine) and How Does it Help Manage Bipolar Disorder?

LamictalAs you may already know, Lamictal changed and saves my life.  It’s the only drug I’ve been able to take since I was diagnosed in 1995. I am always singing the praises about the drug.

It comes with side effects for sure-   the main one being a rash that can be serious. But it’s very, very rare.  Many health care professionals are wary of Lamictal because of the rash, but I always remind people that a potential side effect is just that. If monitored correctly, the potential is small. Also, the rash is normally benign. Make sure your prescriber knows all of the history before saying no to prescribing Lamictal or Lamotrigine. A rash doesn’t mean you can’t take the drug. It often means you just need to start with a lower dose and increase is slowly.

What is Lamotrigine?

The generic form of Lamicatal is called Lamotrigine.  Lamictal is the brand name and is still prescribed. If you search under the word ‘generic’ you can read  my stories of woe regarding the generic form.  It didn’t work for me at all and I went back to brand name Lamictal. If Lamotrigine works for you, that is fantastic as it’s very cheap. If you try it first and it doesn’t work, defintely ask about the brand name Lamictal. Insurance companies will usually allow the brand change if your prescriber explains why.

For most, the generic is just fine. My mother takes Lamotrigine with very few side effects and great results.

In my experiences with my clients as well as my own experience with myself and family members, Lamictal has many, many more benefits than being a mood stabilizer for bipolar depression. I have seen the following benefits for many years:

Benefits of Lamictal

1. It works extrememly well for irritation and mild aggression.  It’s especially effective for negativity.

2. Rapid cycling. Though this is not talked about as much, Lamictal reduces my rapid cycling by at least 50%.

3. Hypomania- the milder mania from Bipolar two.  Lamictal is not an anti mania drug- this is why people with bipolar one almost always take Lithium, Tegretol, Depakote and or an antipsychotic such as Seroquel, Ability, Risperdol or Zyprexa to manage the mania along with the Lamical for depression.  I have bipolar II and belive me, Lamictal helps my hypomania!

4.  Mild psychosis.  Lamictal keeps me more in touch with reality! It doesn’t have strong anti psychotic benefits, but it defintely helps my paranoia.

I’ve seen it change the lives of so many people! I suggest that anyone who is having trouble with bipolar disorder symptoms at least try Lamictal. As mentioned before, it can be started at a super low dose in order to minimize side effects and then kept at an effective dose for a very long time.  It’s considered the least side effect heavy of any bipolar disorder medication.

I have been on Lamictal since 2005. I defintely have side effects off and on from a stiff neck to itching and twitching! When my dose gets too low- I twitch ‘like a maniac!’ as my friend Pam once said. She really found me amusing! It has also stopped working for me before and my dose had to be significantly increased.  The average dose is 250 mg.  My mom takes 125 mg and I take 700 mg!  Making sure it’s dosed correctly is essential as the range of doses is so high.

I just got this comment from Lin:

Hi, my daughter has taken Lamictal for siezures for many years with no side effects. We had just increased her dose and she started developing tics and high anxiety . Her Neurologist said they are both side effects.Hope this helps.

All drugs have side effects, even aspirin. But I always, always look at the payoff of the drug. If it helps more than it has side effects, I am up for it.

If you are having a hard time or if someone you love is having a hard time, it’s always a good idea to talk to a prescriber about Lamictal.

It can change a life!


95 comments to What is Lamictal (Lamotrigine) and How Does it Help Manage Bipolar Disorder?

  • Ann

    I’m an inpatient psych nurse and have been on high doses of Lexapro and Wellbutrin along with some Risperdal for several years to treat my Bipolar II. Finally switched psychiatrists and found someone who warned against high doses of antidepressants because they can make the mood swings worse. Am currently on Lamictal 50mg and tapering up to 100mg to start. Here’s hoping I can wean off the Lexapro 40mg after many years of being on it. I’ve heard that’s hard to do because the receptor sites are decreased on the brain’s neurons after years of use. Just an FYI, Julie, I’ve been giving out your book Get It Done When You’re Depressed to my patients for some time now. Great to find your website.

    • It’s great news you are getting off the anti depressants- though some people can take them with a strong mood stabilizer, they cause way too many problems for most people with bipolar. Lamictal is the drug of choice for us. I am interested to know how you feel once the switch is made. You are correct about getting off Lexipro- do it as slowly as possible. Good luck! Julie

  • Kim

    I was very excited about getting on Lamictal – when I got up to 50 mgs the mania and anger hit me hard. It happens to some people (as all drugs have side effects that vary person to person). I doubt it happens to many Lamictal users, but I did find some patients online who had the same thing – rage, out of control emotions. I hope Lamictal works for you! I know many people who love it. Bummed I can’t take it.

  • Cristina Martinez

    Hi Julie ,

    Please advise if it is best to take Lamictal on an empty stomach first thing in the morning or do you need to take it after meals. What is your advise on this .

    • I can’t give medical advice, but in my personal experience everyone is different. Figuring out when it works with your body is what matters. This is how I handle all meds. I keep a list of when I take something and how I react. Then I modify. You can do the same. Julie

  • Tammy

    I was taking 800 mg a day of lomictal. I dropped to 600 for six. On ths and two weeks ago, I dropped to 400. The dose is still way above “normal”. I just don’t think I need these meds. I totally get and appreciate mental illness. I have been on meds for 28 years. I am a high functioning professional — 12 months ago my life took a huge turn — for the better. I retired and several other external circumstances changed. I want to quit all meds and try it on my own — again, I am not anti meds in any way, nor am I feeling above them. I just wonder if meds have always been the first answer for me and adjusting, increasing and changing them for 28 years has gotten me where I am. Am I way off for feeling this way? Any constructive input would be greatly appreciated. The side effects of tapering down have not been pleasant, but have not been unbearable. I would like to just take the leap and cold turkey the last 400 mg — again input appreciated

    • jrose

      never ever cold turkey any medication! it can cause psychosis, heart problems, and tons of other side effects depending on the drug. I tried to cold turkey paxil a while ago after being on it for years… I haven’t been the same since…

  • I have struggled with bipolar for years too. I have had great success with a supplement called 5-htp. I take two dissolving tablets per day. One in the morning after brushing my teeth and one just before bed. It helps me produce the feel good chemicals in my brain naturally. I also take a vitamin D supplement because I don’t get much sun, and that helps with my mood. The two things I just mentioned have been so effective that no antidepressant is needed. I increased my exercise and I stay away from negative people. Next I take two lamictal tablets twice per day at 25mg each for a total of 50mg per day. This does help with feeling paranoid or nervous. I hope this helps. At times I add a multivitamin and fish oil pills.
    Oh and avoid fluoride in tap water by drinking only spring water. That made a huge difference as well. Good luck!

  • I was put on a 25 mg of Lamictal for the three weeks then 50 mg the last week. The dosage was increased to 200 mg because it was not controlling my mood’s, I then self mediated myself to 300 mg which did not help. I got my doctor to increase the dosage to 400 mg and the worst four side affects is memory loss-concentration (which has affected my grades online at Liberty University) when I started at 200 mg and severe angry outburst when I’ve had enough of someones crap and I’m sleepy everyday. I’ve been on Lamictal for 4 months now. I’ve been on so many different depression pills that did not work and made me gain weight,so I stopped taking them all together without weaning myself with no negative side affects. I am currently on 20 mg a day: 10 mg morning and 10 mg at at night of Valium, 40 mg a day of Adderall, 400 mg a day of Lamictal, and 6 mg of Lunesta so I can sleep at night. I also suffer from essential hypertension caused by a variety of issues like stress for me, I would think all these mental pills would control my stress level period. I’m just tired of all these scripts a shrink prescribing patients meds that do not work, it’s almost like being a guinea pig for trial and error till one or all of these scripts actually work on someone. I’ve tried John Worts for depression and that did not help me and honestly I do not think any drug or vitamin can help me. So if anyone has any positive ideas that can assist me I would greatly appreciate any input.

    • sammy

      As you know the drug are asically a crap shoot and you are under stress. The only thing I can offer is to look at your diet and eat nutrient dense foods and stay away from processed foods…Also if you can take a course in meditation or even see them on you tube and practice it every day It may help. It helped me. For sleeping ther are many tunes you can listen to that will put you to sleep in minutes. I use them all the time. Get an extra small MP player, 8 megabyte would be optimum go to bed and put in your ear buds. you tube has many . I will give you one page but you can search on it for others . You need to convert the tune to MP3 and ther are utilities you can find on the net for free and load it on your player. youtube.com/results?search_query=bilateral+sounds+for+sleeping

      for conversion…. I use this…listentoyoutube.com/

      I wish you peace.

    • Donna

      I am not a doctor, and can’t give medical advice. It seems to me, just looking at your list of meds, that you probably need a second psych opinion. I assume you are taking the valium for your stress level?
      That is quite a large dose. If you are ADHD and you are taking the Adderall for that, then perhaps you need to get that adjusted as well. I know personally, I have had to have that adjusted over the years. If you are struggling to sleep at night and need the valium and the lunesta, perhaps you should ask your psych. about an antipsychotic like Seroquel. My husband takes this and Lithium, along with the Lamictal and he is stable. He would be up many nights until the Seroquel was added. He also suffers from that stress issue and does have to take an extremely low dose of valium long-acting. As long as he stays on his med schedule, he does well. Yes, he does not handle stress well at all. He has gained weight due to lack of exercise and healthy eating habits. It seems to me, that those are extremely important combinations that help with this disorder. I wish you luck in college. I cannot imagine having to navigate college years all while trying to find mental stability. I came here to read about Lamictal because my Dr. prescribed as a helper for my depression. For some reason I felt compelled to comment. I don’t know if it helped you, but a second opinion is always good. Some psychs do try to help by changing up meds to see what works-however, they do not have an accurate picture of what goes on when you leave their office. My mom went through this-finally we got a new psych, and my brother and I went to appts. to tell psych what was going on at home. So, keep a journal. Be honest and have a roommate or a friend go with you and provide the Dr. some feedback so that he can get a clearer picture of what your daily experience is like. We are our own best advocates.

  • Troy

    I have been taking lamotrigine for about 10+ years now.
    I had been seeing different doctors prior to treat my depression. Some were just because insurance changed, others because my progress was not noticeable.
    Since I was 18 I was considered “depressed” and have spent years struggling with having mixed mode episodes, rapid cycling. I am 47 years old now and life is a challenge.
    I left out the middle part where I had gone to doctors explained how I felt and I believe that 15+ years ago Bi-polar was a bad word as well as not understood as well as it is today. When my medicine list only contained anti-depressants and no mood stabilizers hitting the bottom was just the start as my experience with rapid cycling was so quick that there is no such thing as in between. My mania could be really extreme and last for a week or more no sleep was possible for more than an hour. I invented all types of things, I do some programming, so I would write code for hours, then get mad because I forgot what I was doing. This switch would sometimes would happen within an hour Up and down. Suicidal to writing books and programs. Then the damage. I was married for 17 years I have two children who saw me go through this. Going back in time. I worked and still do at the same job today in a technical field. I managed to resist the dark thoughts that go with the low, I only hallucinated a few times in my manic state. I had put my ex through — and back more times than I know of. I over the years from 18+ knew I was depressed I am able to recognize how I felt. I know what goes up comes down. With me I am a yoyo I still look forward to a little mania. I finally had a real diagnosis of bi-polar 1 and after years of anti-depressants I have taken everything you name it, and multiple Phys hospital visits. A doctor gave me lithium and I knew life was changing. I still had not been able to make the doctors believe that I could be happy sad and have a mood change in an hour or less for day, then I would stay depressed probably for 3- 5 months then it would hit mania for days I did this for years. I made mistakes I told my ex how I felt like driving into trees and crashing the car because I was having a stressfull day. The next day I was so happy as I had a good day and wanted to go out for dinner so she did not have worry about dinner, even though I also have OCD and always cleaned the dishes by hand and then dish washer then put them away. Then one day .. like a story I was given Lamotrigine and life changed. I had a doctor who listened and ask questions besides how do you feel today, how about 2 months ago from today he asked, or last week. I responded with the past I explained what happens and seroquel was added, the two anti-depressants were dropped. I had learned even before the change to new meds that dropping the anti-depressants was risky I was on lithium, so at least the rapid speach and overtalking the doctor gave him a clue, my panic attack’s were frequent and xanix, helped and ambien well it at least gave me the ablility to belive i could take something to sleep as insomnia is now today just a part of my life, but then years ago I dropped the effexer, prozax. . I went for it like all new meds it takes time, I do know that everyone responds differently. Lamotrigine has been the most effective medicine I have ever taken. I am very cautious about stating how well one medicine works. Your doctor is your life line just because one med works for one person might not work for another before stopping anything because you read it on line or someone told you is no reason to stop taking it. I say this because I think that you and your doctor and your medicine is your business. My point is just because I stopped taking anti-depressants and have been diagnosed with bi-polar 1, with mixed mode rapid cycling. and took anti-depressants does not mean you need to stop. It works both ways some people when they are stable can take mood stabilizers and anti-depressants. If your reading this by now you see what I am trying to do is tell you ask your doctor before you do anything. Now, that you see that. There is nothing wrong with asking questions then ask your doctor. I struggled for years. I lost a marriage due to what is now a more treatable problem with many people. As I sit hear and write this a commercial on tv came on about Bi-polar and a medicine for it. I will say this I have another family member that has been diagnosed with bi-polar and they are an adult however they are young and feel the need to stop talking lamotrigine a month or two after they feel better. I can only say I wish that I had this medicine years ago. I am thankful for those who suffer from this diagnosis as many people do. That they symptoms are now more recognized and those who need it are offered this medicine to try now today rather than wait years as I did.
    I have since because of other issues, which I believe are stress related, have had 2 heart attacks, and a triple bypass. SO I urge anyone who has stress, or depression or other issues that you are not alone and ask, don’t keep it to your self all the time. seek help I never gave up as painful as the lows can be as sad as I have felt. I know that there are some people who do not believe that medicine can help. When your mixed up with sad, happy, up down, can’t get out of bed, nothing is helping feeling. Then consider asking me. I am stable, but have my bad days, remarried and have a friendship with my ex. my children have both graduated from college. Suicidal thoughts that still come and go. I still have some noticeable ups and downs but its rare. I know have a low EF rate basically heart failure, and have an ICD, – a defibrillator- I still work as I choose too, I still deal with depression. Take away my mood stabilizer. I honestly can’t imagine now how much of challenge it would be. If anyone has been recently diagnosed with Bi-polar and is new to the medicine how are you doing so far, or how are you now after taking this medicine now after years like I have been doing 400 mg per day. Thank you for your time. Troy

  • James Hungelmann

    Before getting on this drug, you must exhaust options around pure fresh foods-based nutrition and healthy balanced cardio and strength training with Yoga.

    • Most of us do this for many years before trying any kind of medication. I know that I did. Bipolar disorder is an incredibly complex illness that rarely responds only to diet and yoga. They are a wonderful addition to a management plan, but some kind of help beyond these steps is usually needed.


    • S D

      How ignorant you are. Clearly you have never had a person close to you with an extreme brain based chemical illness.

  • Tina

    Gained tons of weight on the cymbalta and Wellbutrin combo. Don’t want to gain weight on lambictal. Will I 25 mg to start then 100