Newsletter: Lamictal and bipolar disorder sleep problems

Hi Julie,

I was recently diagnosed with bipolar.I am now taking Lamictal. The only side effect Ive had is sleeplessness. I ‘ sleep, I cant sleep, I quit coffee. I quit drinking coke. I have done everything to sleep. I get maybe 3 hours if ‘ lucky. I’m new to this drug on my first week so I am on a low dosage. 25mg. for the first 14 days. Does this get better?? Do you sleep finally as the dose gets bigger! UGH!!

Hi Deborah,

There are so many different side effects with each drug.  The drugs can even cause opposite side effects such as making one person sleepy and the other revved up. I have not heard of Lamictal causing sleeplessness, but it’s certainly a possibility.  Also, that really is a small dose. It’s very good to start small and go up. The general dose is 250mg though it ranges greatly. My mom takes 100mg and I take 500mg! I started at 10mg.

Sleep problems can really exacerbate bipolar disorder as they can lead to mania- on the other hand- mania can cause the sleep problems. Here’s how to know the difference:

When a person has sleep problems with mania, they don’t tend to be tired the next day. They can get up and get on with their day with energy.  Do you feel normal the next day?

Sleep problems due to a drug often make the person tired, upset and unfocused the next day- or even abnormally tired, such as falling asleep in the middle of the day and drooling on a pillow. I call this pass out sleeping.

The question is how you feel the next day after you don’t sleep.

Next question, Did you try any other meds before you went on  Lamictal? Are they still in your system?

Side effects definitely lessen, but sleep issues are too serious to ignore. I would talk with your doctor and explain the symptoms. It may be you need a sleep aid such as Ativan (which is what I use) to help you sleep so the Lamictal can work. But… you don’t really want to take that every night. Another option is one of the new drugs such as Lunesta. Also, ask your doctor about using Benedryl as well. All of these have risks.

There are definitely choices, but you really need to tell your doctor what is happening as you have to make sure it’s not mania!


PS: Here is some advice from Shana:

Hi Julie, just wanted to let you know that sleeplessness is a side effect of lamictal. Strangely, it is not one identified often by the manufacturer or by medical sites. However it is repeated as anecdotal on various side effect forums on the ‘net.

I myself experienced it. It was terrible. Thankfully it went away after a few months!

** I love to hear from readers who have experienced similar symptoms. So now we know- Lamictal can definitely cause sleeplessness- when this happens, definitely talk to your doctor and get some sleep help. You may need to change drugs. many of us, Lamictal is definitely worth it. I really need to start calling it Generic Lamotrigine!


PS: Lamotrigine is the generic name for Lamictal

38 comments to Newsletter: Lamictal and bipolar disorder sleep problems

  • Shana Rosenberg

    Hi Julie, just wanted to let you know that sleeplessness is a side effect of lamictal. Strangely, it is not one identified often by the manufacturer or by medical sites. However it is repeated as anecdotal on various side effect forums on the ‘net.

    I myself experienced it. It was terrible. Thankfully it went away after a few months!

    Hi Shana,

    I am glad it went away! It’s good to get information straight from people who take the drug. I have a breathing problem from Lamictal that most people don’t get. It’s an odd one- I feel a great desire to yawn, but I can’t. It’s often very uncomfortable. It usually comes and goes, but the generic Lamtrigine has defintely made it worse. I agree, side effects often lesson over time. Julie

  • Lena


    It took nine months before I could sleep without some sleep aid. Low doses of Zyprexa or levomepromazin helped.

    Hi Lena,

    A friend of mine has had trouble sleeping and her doctor suggested that she use a small dose of Zyprexa. She knows it will work, but she’s scared to feel like a zombie again. She just started a new job. It’s frustrating for her. Others use the Zyprexa with great success.

    levomepromazin is an anti psychotic that has strong sedative effects. I can see how it would work like Zyprexa in terms of sleep. Currently, levomepromazine is not registered in the USA. In Europe it has been marketed for decades as Neurocil® and Nozinan®. Nozinan® is also available in Canada.

    Severe sleep problems are really dangerous for people with bipolar disorder, so if you’re having trouble sleeping, talk to your doctor and get more information. Also, make sure your sleep problems are not a result of mania! Julie

  • dave

    hey julie, can you discuss ssri sexual side effects. i am sure you would receive many reader comments. i am not sure it is appropriate for your site but this is a huge noncompliance issue. many times i have compromised my health by refusing ssri’s because of sexual side effects.

  • abby

    lamictal seems to be making me sleep all of the time. The sleeping all day makes me depressed ,i dont know if it is the meds or me

    • Kenton

      Same here. 125 mg now. The higher the dose the more I sleep. I’m not cycling as much — had a fast cycle problem. I am more in conrtol WHEN I’m awake. Sleeping any where from 12 to 18 hours a day. It’s as if I’m in a low, but I’m not.

  • juice

    I just started on Lamtrigine 25mg..I’ve been on it now for about 14 day’s..for bipolar disorder..I also take fluxtine 40 mg..I am suppose to increase my dosage to 50mg.on the Lamtrigine..I can’t seem to do it because of fear of the rash..I have had the hives in the past..I hate it..
    I have learned starting a low dose is good to keep you from getting the rash..I also have noticed I have constipation and head-ache and neck ache..Will this go away?

  • just started with Lamictal 1/4 of 25 mg. Took at 7 p.m. and yeah, can’t sleep. Will try in the morning but if it persists for too long good bye lamictal.

    • Hi, it can take months for a drug to calm down in the body. 1/4 of 25 mg is an incredibly low dose. The average dose is 200 mg! But I know we are all different. Are you on anything else? You would probably need a much higher dose to get the benefits from the drug- it’s hard when the side effects are strong.

      Have you taken it in the early morning? If it keeps you awake, you will need to change the time you take the med.

      I spread my meds throughout the day- oh, it’s so much work! But I’m doing better.

      Good luck! julie

  • Tony

    So I’ve started on this drug about three weeks ago and, while I’ve been able to sleep, my wife has told me I’ve started to move around violently while I’m asleep. She said I’ll start kicking around and even at times throwing my arms around, leaving her all bruised up the next day. She’s actually started to sleep in the guest bed as she just can’t take being in the same bed with me, it’s really tearing me apart… Has anyone else experienced this? I looked it up and it best describes PLMS, however the only sleep side effect I’ve found for this drug has been a myoclonic jerk.
    If anyone has any suggestions on how to fix this it’d be great, I’d rather not stop this medication as its basically my only chance of leveling out in the day time

  • Hello To All,

    I have been taking Lamical for around 6 months now and am up to 125 mg each day. I have been experiencing 4 whole nights without sleep and did not link this with this med. I have felt very ill because of this. I am now going to slowly and safely come of this med because the side effects are worse than the benefits of it.

  • Dij

    Can you tell me if everyone who takes Lamical have insomnia? or just some of us? I’ve been on it for 2 weeks and am lucky if I get 4 hours of sleep a nite. I’m going to get my doctor to prescribe a sleeping pill and hopefully that will help.

  • beepbeepboop.

    Just started this med. Trouble getting to sleep and staying asleep. Weird dreams and kicking around like a spastic has also woken me up

  • Sweetie

    So much to respond to!

    First, I don’t agree with most medical advice to increase every 2 weeks if a person is experiencing side effects. I think 4-6 weeks or longer shows more common sense. I trust a doctors judgment if he suggests discontinuing a drug rather than increasing it if it causes problems.

    Secondly, even .25 of a 25mg tablet of lamictal causes me severe insomnia, headaches, neck, back and even tooth pain. My doctor supports my decision to add a sleep aid (lunesta in my case, 2mg) and trusts me to be the determining judge in whether to continue or discontinue taking any and all medications.

  • Jade

    I have been on Lamictal for 8 months now (100 mg), and it has been a lifesaver for my bipolar 2. I have had horrible sleep issues the entire time. I have to take melatonin to get any sleep at all, no matter how tired I am. Even last night I took Trazadone and was awake until past 2 am. Even with melatonin, I wake up super early. It has been an ongoing battle, but I do NOT want to stop the drug. After reading some more about it, I might try taking it in the morning, but I have a seriously hard time remembering to take pills in the morning.

  • Pam


    Be careful with taking melatonin as I have read a number of articles that it is contra-indicated for BP as it can actually cause some hypo mania

    • Hello Pam,

      I have not heard this. I would love to share some links on this topic. I use a small amount of melatonin in with my sleep meds. I have had TERRIBLE problems with valerian, so it has a lot to do with our own physiology. St. John’s Wort definitely has connections with mania, but I would like to see more research about the melatonin. Thanks for bringing this up! Julie

  • bridgette nkosi

    I started taking 25 I’m on the 9th day and 2nd day of 50mg and my sleep has been horrible,I’m worried because I went for concentration issues and not Sleeping is setting me back,I also struggled with insomnia for about 2 years,and had recently improved so it’s freaking me out

    • It’s good to be freaked out about not sleeping because it’s one thing that we have to take care of immediately. I recently had a huge change in my sleep – I now take 150 mg of Trazadone a few hours before bed and .5 mg of Melatonin four hours before bed. I’m off Ativan. I’ve not heard much about Lamictal causing sleep problems, though meds work differently in each person. 50 mg is a low dose- so it’s important to figure out if it is causing sleep problems before you go up to the therapeutic dose of around 200 mg. Here are questions I ask myself when I cant sleep.

      1. Am I manic?
      2. Am I in a bad relationship situation?
      3. Is it a medication side effect?
      4. Did I recently make a big change that could lead to the sleep issues?
      5. If it is a medication, do I need to talk with my prescriber immediately?

      Can you pinpoint the sleep issues directly to starting the Lamictal and not to anything else? If so, I would talk with your prescriber and get some help – as you can tell, sleep is precious to us! Good luck, Julie

  • Becca102413

    Ok so I’m 17 and I was just diagnosed with bipolar depression 1 or manic depression and ptsd and I have been taking lamictal for 5 days and I haven’t slept but like and hour each day and it is really hard to sleep and when I try to sleep i have horrible dream things I guess and so is it normal not to be able to sleep?

  • Eica Nicole Napier

    Last comment messed up. K i started lamaticol for weeks ago at 50 a day for. Two weeks then up to four 200mg i cannot sleep! I feel like manic what treats that?

    • Hello Eica,

      We all react differently to medications, but Lamictal tends to have similar side effects for most people. BUT…. I have heard of people who have mania from Lamictal. For those who do take meds, I feel that Lamictal really does help people greatly. It has a high dosing range- I suggest you tell your prescriber what is going on immediately- the combination of side effects and no sleep is a dangerous one. You need to stop the mania now- it’s possible! I suggest you share with your prescriber that you might have gone up too quickly- I can see you went from 50 to 200 mg in a short time and that can cause mania and other side effects. Ask if you can go back down to 50 mg and then titrate up 75 for a few days- if you feel ok, then 100mg for a week and then so on until you find a therapeutic dose. The average dose on Lamictal is 200, but a therapeutic dose varies wildly. My plan would be to call the psych, get help with sleep, reduce the mania by reducing the Lamictal and then go from there. Don’t give up on the process- it can take time! The good news is that I am now on very low doses of meds, I sleep well and my mood swings are minimal if I follow my Health Cards. The same can happen for you! Julie

  • Hi Eica,

    Wow am I reading this right! You were taking 50mg of Lamictal a day for 2 weeks, then you went to 200mg 4 times a day? Can’t be right. If that were the case, call another doctor immediately , that is simply nuts. I will go with what is more realistic. You went from 50mg to 200mg in a 2 week time span. Julie is right. that is way to big of as jump in to short a time frame. I take 450 mg a day and have been for 10 years. Lamictal is a anti-seizure medication. Bi-Polar in full swing is effectively a “seizure”. I used to call them lighting storms. Fine for awhile and then I would go nuts. Super high great mood,”mania” shifting into cannot focus out of control behavior. (One time I bought a house, thank god it did not go through.) The swing downward is depression and hopelessness. Great stuff right? If you think about it this type of behavior moderate to severe is not going to get fixed in a short period of time 1-4 weeks. And a little bit of medication is not going to fix a big problem. The brain is not going to give in so easily. In essence we are programming our brains to do something other than what it has been doing for a long time. We are straightening out a chemical imbalance by putting a chemical into us that will give us the balance we are supposed to have. It takes time and small steps up the ladder to success to get there. 25mg-50mg-100mg-200mg and so on. It took me four months to get to 400mg. The process was uncomfortable and I did have side effects like sleeplessness to overcome. I complained about the anxiety and sleeplessness and I was given clonazapam, 0.5mg 2xs a day. It is not a lot, but it did the trick. Clonazapam is an anti-anxiety med. Bi-Polar and anxiety are a common duo in this bi-polar issue. One is neurotic and the other psychotic. I found out that when I treated the nerves,(calmed me down), I had less problems with the side effects of the Lamictal that I was taking to calm my head! Nerves and mind are very different and in my case are treated separately but together to achieve a calm person with a level head. I bet no one saw that coming. I am not a doctor!! I cannot recommend anything to anyone. I did however battle the drug therapy issue for 2 years before finding the right cocktail. It saved my life. Keep in mind everyone!!(no pun intended) it takes time and patience and is not comfortable to change…I found it downright brutal, but stick to it!!!. Doctors prescribe this stuff because it works in so many patients. Give it a chance. Longer than 2 weeks is a must, Just can’t re-wire your brain in 2 weeks. If your situation is not getting better take a different pill, get another doctor, do something, (never take yourself off of anything without a doctors approval. The results can be horrible). I hung in there for over 2 months and it all started to come together. The side effects did go away. I am a different person today. I never deviate from my med-program.
    Good Luck!!

  • I’ve just started Lamotrigine and I’m having trouble sleeping on 25 mgs of it but I’ve had sleep trouble for years. Somehow I make it through the day though so I’m wondering if I’m just in a light sleep and just waking up a lot. I seem to have good energy throughout the day but it’s only day 2, but I was dead tired all day before this. I feel a little weird about 1/2 hour after taking it in the morning. I do take Dexedrine to help with energy throughout the day but I’m scared to take in afternoon in case my sleep is worse. I take Lunesta every night to help with sleep but wake up at 2 and 4 and 5 every morning. I guess this will be my life as I know it.

    • Troy

      I’m on night number 3 starting 25mgs of Lamotrigine. The first night I felt anxious and somewhat agitated prior to taking it. Shortly after I took it I felt more relaxed. Despite waking up a few times throughout the night, I felt great the next day. The next night, however, I hardly slept and felt horrible. I was tired and irritated all day… had a difficult time being productive or able to enjoy anything. After reading online I recognize many side effects that I am having, and I sit here now unable to sleep (yet feeling too tired to do much). I feel I was much better off prior to taking this med. I understand it may take a long time for the full effectiveness to realize, but I fear that these side effects may be greater than any benefits I may see. Sigh…

  • itook lamictal one night only and had trouble sleeping and frlt very sick the next say.weak,angry nausated

  • Dawn

    I’ve been taking 100 mg of Lamictal since I was diagnosed with bipolar disorder in 2009. And ever since I started taking it, I could not sleep at night. When I told my psychiatrist I could not sleep, he prescribed Seroquel for me. So taking that, it put me to sleep the first night I took it. Still on it now, I’m at 200 mg per night with it. And it’s also an anti-psychotic for bipolar disorder and I think it helps with mania. Take some other meds too, and have tried other things for sleep but Seroquel is the only one that has worked to give me a good amount of sleep, 7 even 8 hours some days. Risperidone actually made things worse, restless and hyper. When that new drug, Saphris, came out I tried it and it only gave me about 4 hours sleep and didn’t seem effective as an anti-psychotic. Another new drug, Geodon, that is out lists restlessness as one of its side effects, so definitely not trying that one, plus it’s probably pretty expensive anyway, being new. So I can get Seroquel for $10 at Sam’s Club with a Plus Membership and that’s with no insurance! Game on.

    • Thank you for this fantastic information! Julie

      • Dawn

        My pleasure. I just stumbled onto this area today and added a comment. If it helps someone, great. Of course, everyone’s chemistry is different, so Seroquel will work well for some people and not others. You have to try the drugs until you find the one that works for you. As far as not having insurance, shop around. There are great plans out there. I get all my meds for low prices by finding the RX discount plans at different pharmacies. Sure, I go to three pharmacies but it is worth it. The plan at Albertson’s OSCO gets me the generic Lamictal 100 mg for $4 a month instead of $88 if you pay for the $11 per year membership. A local pharmacy gets me .5 90 pills of alprazolam for $7.52. And Sam’s, like I said, gets me Seroquel 200 mg 30 pills for $10 instead of over $100, 200 generic Topamax for 30 pills $10 instead of close to $100 and 600 mg Lithium 90 pills for $10. The plans do cover only certain amounts of milligrams so you have to check. Like the lithium is 300 mg for $4 and 600 for $400 but the 450 mg is not covered and costs around $30. Anyway, the copays are less than my insurance was in most cases. So, again, shop around. Walgreens is usually the most expensive.

      • Doesn’t seroquel make you gain excessive weight? I am on Lamictal and Lexapro and I haven’t slept one night since. I try to get off Xanax over and over shah but I just can’t sleep. Any help?

        • Hello Lisa,

          Yes, Seroquel can make you gain weight. Not sleeping is one of our biggest symptoms and triggers. Talk with your health care professional and make sure the Lexipro is not causing mania. Julie

        • Dawn Lynn

          Yes, Seroquel doesn’t work for everyone. And yes, it has caused me to gain weight. 🙁 I have actually gone off the Lamictal since I replied in here back in January. I am taking lithium instead. So now it’s lithium and Seroquel. I still have trouble sleeping if I don’t take an anti-psychotic like Seroquel. I’ve also added topamax which gives an appetite suppressant effect and I’ve slowly been losing a little weight. Very slowly, but better than gaining.

  • Kelsey

    Hey all,

    I too have suffered with sleeplessness since taking lamotrigine (lamictal). I was taking 25 mg of seroquel which would help me more than nothing. However, I just increased my lamotrigine to 150 from 100 (after awhile of being on 100) and that really helped. I’ve slept the whole night through for the last couple of nights WITHOUT taking seroquel.

  • virginia

    I just started a low dose of lamictal and I have experienced sleeplessness since I started it. I wake up and I experience nausea all day and even have had nights where the vomiting is so bad I sleep next to the toilet. I wake up with headaches and I have tried taking Benadryl but it doesn’t make me sleep either. I have serious stomach cramps all day and some days I feel even more depressed than I did the day before. I am also taking clonidine but I don’t feel anything from this. I am at a loss of what to do since I want the help but I’ve tried fluoxetine and also Trintillux. Neither seemed to make a difference.

  • Carrie

    I began taking lamotrigine at 25 mg and have titrated up every two weeks. At 100 mg I was doing fine, but my doctor said that 209 mg is a therapeutic dose for most. Immediately after going up to the 200 mg sleep went away. I had been taking Seroquel 25 mg, so she raised it to 50 mg, which leaves me in a drugged out stupor the entire next day dampening the good effects of the lamotrigine. Ugh! I’m going to discuss with her on Monday going back to the 100 mg and see if that helps. I think there’s a sweet spot for everyone dosage wise. There’s no way one size fits all.

  • Layney

    I’m on 200mg lamotrigine. I went from 100 to 200, feel great as far as anxiety and bipolar symptoms, but lots of troubles sleeping. I can go to sleep, but sleep restlessly and rarely for more than two hours at a time. I feel exhausted every morning, ok during the day, and then exhausted at night. I was taking it at night and my doc advised me to take it in the morning instead, but I don’t see much difference. However, that might help some people, I dont know. I dont want to go off it, as its the only medication I’ve been on where I’ve felt stable. I’m thinking of trying Melatonin before last resort, which is another prescription.

  • Sue

    I have had Sleep problems for years. I take 600mg of lamictal a day (yes you read that right, 200mg three times a day) For a long time seroquel (at a measly 25mg) did the trick of knocking me out, but for the last couple of years I’ve been sleeping for 2 or 3 hours and then lying awake for 3-5 hours until I fall asleep again about an hour or 2 before the alarm goes off. It was miserable. Sleeping tablets (restoril or Sonata) either didn’t work or made me foggy.
    I was having issues with weight so my doctor decided to switch me from seroquel to trazadone at night. For about 2 weeks it worked then it was back to the old pattern. I recently discovered a natural sleep aid with melatonin as one of the ingredients and it’s been amazing. If I do wake up in the night and can’t get back to sleep, I take a second dose.
    It never occurred to me until I read this post that lamictal could be contributing to my sleep problems. But today I made the connection between my mid day dose and incredible sleepiness. Today I was driving and 20 minutes after my lamictal I had to pull over and ask my husband to take over. It was a light bulb moment. Maybe the midday lamictal is connected to the incredible fatigue I feel in the early afternoons. I used to think it was lunch-lag but I am wondering if it’s the lamictal.
    Is it possible that it could make me sleepy, and then also cause sleeplessness after a few hours?
    Is anyone else in this forum on as high a dose as me.?

    • Sue

      I might add that for Many years I was taking 200mg twice a day. The increase was a fairly recent thing, just in the last year because my blood levels were testing so low. It seems I metabolize lamictal very very quickly. After 12 hours at 400mg my blood levels barely registers- 1.5 when the range should be between 2 and 20. At 600mg I test at a blood level of 6 and my psychiatrist is amazed. So anyway, the early afternoon fatigue may be connected to the mid-day lamictal. I’m connecting the dots and wondering if anyone else gets sleepy after lamictal
      On a side note, since stopping seroquel I have had loads more energy (of the good kind) and my joy has returned. I’m so happy I stopped that one. I had no idea how it was dragging me down until it was gone.

  • Carrie

    I was on trintellix for a few years to treat anxiety which seemed to help, but was experiencing deep, mind numbing depression. My psych Dr added in lamotrigine and titrated me up to 200 mg. It was like a light went on, and I felt like my own self. However I began having some sleep issues. She added 25 mg Seroquel which helped for a while. She switched my trintellix to buspirone because the trintellix was causing terrible constipation issues plus with trintellix you can’t take NSAIDS. Since adding the buspirone I went from having a tough time falling asleep to not being able to fall asleep at all. Even with .5 alprazolam and 50 mg Seroquel (I went up). Whenever I doze off I get a muscle jerk in my body which wakes me up. Over and over again so I give up and get up. Not sure which is worse, the lamotrigine or buspirone. I know it’s not mania because I am wiped the next day. It seems all of the benefits I was experiencing with the lamotrigine are gone because of the insomnia. I put a call in to my psych doc today. I hate switching meds and waiting for results which can take a long time to work. Not sure what the answer is.

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