Side Effects of Lamictal to Be Aware of

Lamictal (lamotrigine) is a seizure medicine prescribed to treat symptoms of epilepsy, but it can also be used as a maintenance drug for managing depressive mood episodes and mood swings in adults with bipolar disorder. It’s also sometimes used off-label to treat unipolar depression (a major depressive episode). Lamictal is in the class of drugs known as anticonvulsants, which are believed to work by lowering abnormal electrical activity in the brain and reducing excitability to combat mood episodes and mood swings. 

Though effective for some people, Lamictal treatment can cause a variety of side effects, ranging from mild to severe to extreme, so it’s important to understand this seizure medicine before taking it. If you have questions, make sure to discuss them with the doctor prescribing the medication.  

Read on to learn more about the various adverse reactions and side effects of Lamictal.  

Common Side Effects of Lamictal

You should always be aware of the side effects of Lamictal — or any drug you’re starting. 

Lamictal is a fast-acting drug used as a mood stabilizer — it peaks in the body within around 1.5 to almost 5 hours after taking it. Your doctor will likely start you on a lower dose and gradually increase the dosage every few days or weeks until you see optimal results. 

For some, finding the proper dosage can take as long as 6 weeks, at which point they may begin to feel positive results. When taking Lamictal for bipolar depression, you need to be patient, as you’ll probably need to take this drug for 6 months to prevent symptoms of bipolar depression from returning. If the medication works well, you might take it even longer. 

Lamictal’s effectiveness can last longer than 24 hours, so it’s generally used as a once-per-day dose. Because it can cause sleepiness in some people, your doctor might recommend a divided dose of Lamictal daily to reduce the risk of drowsiness. 

Other common side effects of Lamictal can include:

• Nausea or vomiting  
• Drowsiness
• Changes in blurred or double vision
• Changes in urination output
• Increased sweating
• Tightness in the chest
• Feeling more clumsy or uncoordinated than normal
• Irregular heartbeat
• Pain in the jaw
• Change in breathing pattern
• Feeling unsteady
• Discomfort in arms, back or neck
• Dilated neck veins
• Rash
• Swelling in the face, lower legs or feet, and fingers
• Weight gain

*Note this list is not all inclusive

Less Common Side Effects of Lamictal

There are also a few less common side effects of Lamictal that you should be aware of. For example, some people who start taking Lamictal experience:

• Chest pain
• Anxiety
• Rolling, uncontrollable, continuous eye movement
• Confusion 
• Increased seizures
• Depression
• Irritability
• Infection 

*Note this list is not all inclusive

Though not as common, it’s still important to tell your doctor if you have any of the side effects of Lamictal listed above. Only they can determine if a different dosage or new bipolar disorder medication might improve your symptoms with fewer side effects and adverse reactions. 

Serious Side Effects of Lamictal

Occasionally, some — though not many — people will have Lamictal (lamotrigine) side effects that are more serious. While rare, it’s important to know about the following potential side effects, as some can be life-threatening. 

Call your doctor or 911 or go to the nearest emergency room immediately if you experience the following. 

Stevens-Johnson Syndrome (SJS) & Toxic Epidermal Necrolysis (TEN)

Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare skin conditions most often caused by medications like Lamictal. 

Research found that these skin syndromes are the result of the body being unable to detoxify the drugs it sees as foreign. In response, cytotoxic T cells attack the mucosa/epidermis layer of the skin. 

Aseptic meningitis

The Food and Drug Association (FDA) notes that while Lamictal-associated aseptic meningitis isn’t common, it is a serious potential side effect that causes symptoms like fever, headache, chills, stiff neck, abnormal sensitivity to light, confusion, and more. Symptoms often occur around 16 days after starting the drug and can cause hospitalization. 

Angioedema 

Angioedema, or a hive-like swelling beneath the skin, is a noted skin reaction that an overdose of Lamictal might cause. This rare skin reaction can lead to anaphylaxis in some cases, causing severe swelling throughout the airways and lungs.

Hemophagocytic lymphohistiocytosis (HLH)

In studies, hemophagocytic lymphohistiocytosis (HLH) results from an adverse reaction to Lamictal. HLH is a very serious, almost always fatal, hyper-inflammatory condition that causes multiorgan failure. In the most severe cases, it can cause death.

If you have any of the following symptoms after taking Lamictal, you should get medical attention as soon as possible:

• Swollen lymph nodes
• Jaundice 
• Enlarged liver
• Difficulty breathing or lung issues like coughing
• Nervous system issues — headache, visual disturbance, weakness, trouble walking

Suicidal thoughts or actions

According to research, Lamictal and other antiepileptic drugs can increase the risk of suicidal thoughts or actions. If you’re experiencing increased suicidal thinking, it’s essential that you immediately reach out to your doctor or go to the nearest medical facility.  

Severe allergic reaction

Severe allergic reactions (also known as anaphylaxis) are associated with Lamictal and can cause:

• Sudden swelling of the mouth, lips, tongue, or throat
• Tightening in the throat, difficulty swallowing, and feeling of sore throat
• Difficulty breathing
• Suddenly feeling extreme confusion, dizziness, or drowsiness
• Skin or lips and tongue turning gray, blue, or pale

“In case of a fever, muscle stiffness, sore throat, dizziness, or fatigue, inform your doctor immediately.”

– Talkspace psychiatrist Dr. Muhammad Munir, MD

Multiorgan hypersensitivity reactions

Studies linked Lamictal to drug-induced delayed multiorgan hypersensitivity syndrome (DIDMOHS) in about 1 out of every 300 adults. This is a rare but potentially fatal reaction caused by some drugs. The most common symptoms are skin rash and fever. 

“In case of a rash, inform your doctor urgently, and if possible,  get it checked as soon as possible.”

– Talkspace psychiatrist Dr. Muhammad Munir, MD

How Long Do Lamictal Side Effects Last?

For the majority of people who take Lamictal, side effects are very mild and resolve within a few days to a few weeks with continued Lamictal treatment. Because Lamictal dosage needs to be gradually increased to prevent side effects, the drug can take about 6 weeks for Lamictal to fully work.

“Common side effects of nausea, headache, and upset stomach subside after a few days.”

– Talkspace psychiatrist Dr. Muhammad Munir, MD

How to Manage Lamictal Side Effects

Most Lamictal side effects, especially those that are mild, don’t require any medical attention and will go away as you adjust to taking the medication. If they’re bothering you, though, try the following to manage side effects:

• Try taking it with food if Lamictal upsets your stomach
• Take exactly as prescribed
• Stay hydrated
• Eat healthy
• Avoid alcohol and marijuana 
• Do not suddenly stop taking this medication

Talk to your doctor if side effects continue or begin to outweigh the benefits. 

“Do not stop the medication cold turkey, as that can be very dangerous, depending on the dose of the medicine.”

– Talkspace psychiatrist Dr. Muhammad Munir, MD

See If Lamictal Is Right for You with Talkspace 

Lamictal can be effective in stabilizing mood swings that are associated with bipolar disorder. Only you and your doctor can decide if a Lamictal prescription is right for you and your symptoms. 

If you’re considering starting a new medication to treat bipolar disorder, Talkspace can be your lifeline. Get paired with a licensed psychiatrist today to discuss your options for treating bipolar or any mental health condition via medication and therapy for bipolar disorder so you can get back to living.