Home Medicines Lamotrigine: effect, areas of application, side effects

Lamotrigine: effect, areas of application, side effects

by Josephine Andrews
Published: Last Updated on 457 views

As a second-generation antiepileptic, lamotrigine is one of the most important therapeutic agents for seizures, but is also used to prevent depressive episodes in bipolar disorder. The active ingredient is generally well tolerated. Possible side effects include skin reactions and headaches. Because of its good tolerability, lamotrigine is the drug of choice for pregnant women. Here you can read everything you need to know about lamotrigine. 

How lamotrigine works

Effect

Lamotrigine is an active ingredient from the group of antiepileptics with antiepileptic (spasmodic) and mood-stabilizing properties.

The human nervous system is activated or inhibited by certain messenger substances. Normally, these messenger substances are released according to the external circumstances and ensure an appropriate reaction of the body to different situations such as injury, stress or rest.

In diseases of the nervous system, this controlled balance is disturbed. Excitation can be increased or inhibition reduced by a genetic predisposition or by injuries to the brain. The nervous system of the brain is then overexcitable, which can lead to epileptic seizures.

Lamotrigine reduces hyperexcitability by blocking certain ion channels (mainly voltage-gated sodium and calcium channels) in nerve cells, thereby reducing the risk of an epileptic seizure.

Because of its mood-stabilizing effects, lamotrigine can also be used to prevent depression in people with bipolar disorder.

intake, degradation and excretion

Lamotrigine is rapidly and completely absorbed from the intestine into the blood. The maximum effect occurs after about two and a half hours. The active ingredient is broken down in the liver and then excreted through the kidneys.

The time after which half of lamotrigine is broken down in the body (half-life) is between 24 and 35 hours.

When is lamotrigine used?

Lamotrigine uses (indications) include:

  • Monotherapy and adjunctive therapy of certain forms of epilepsy
  • Lennox-Gastaut syndrome (rare and severe childhood epilepsy)
  • Prevention of depression in patients with bipolar disorder

How lamotrigine is used

Lamotrigine is most commonly used in tablet form, but there are also suspensions that are easier to swallow. It is usually taken once a day. It is recommended that the tablets are taken at the same time each day, before or after a meal, whenever possible.

The appropriate dose is determined individually for each patient. First (weeks one and two) you start with a low daily dose of 25 milligrams. In the third and fourth week, the daily amount is increased to 50 milligrams per day.

Depending on the patient, the so-called “maintenance dose” is then (from week 5 of treatment) 100 to 200 milligrams daily.

This dosing regimen, also called “up-titration”, is used when no other antiepileptic drug is used in addition to lamotrigine. In combination treatment with other active substances, the lamotrigine dosage may need to be adjusted.

Patients with kidney and liver problems and children aged two to twelve years receive a lower dose.

It is imperative that women who are taking hormonal contraceptives tell the attending physician. In this case, the lamotrigine dose must be increased. The dosage must also be adjusted again when the contraceptive is discontinued.

What are the side effects of lamotrigine?

Very common side effects (one in ten patients) are headache and skin rash. Dizziness, tiredness, sleep problems, aggressiveness, irritability, nausea, vomiting, diarrhea and dry mouth are common (one in 100).

Uncommon side effects (one in 1000) are blurred vision and increased sensitivity to light.

Inform the doctor treating you if you develop skin rashes, especially at the start of therapy.

What should be considered when taking lamotrigine?

interactions

Lamotrigine is broken down in the body mainly via so-called UDP-glucuronyltransferases (special enzymes ). Other drugs or foods that interact with these enzymes may therefore increase or decrease the effects and side effects of lamotrigine.

Drugs that promote the breakdown of lamotrigine and may therefore require an increase in dose include other antiepileptic drugs (e.g. carbamazepine , phenytoin , phenobarbital, primidone), certain antibiotics (e.g. rifampicin ), some HIV drugs (e.g. lopinavir/ritonavir, atazanavir). /Ritonavir) and oral contraceptives (” pill “).

Valproic acid (antiepileptic), on the other hand, inhibits the breakdown of lamotrigine and may therefore make it necessary to reduce the dose to avoid increased side effects.

age restrictions

The use of lamotrigine depends on its indication. In general, the active ingredient should not be used in children under the age of two, as there is not enough experience in this age group.

pregnancy and breast feeding period

Lamotrigine is the drug of choice for epileptics during pregnancy. Although studies have shown that the risk of malformations in the unborn child is minimally increased, the benefit of the treatment outweighs it.

For this purpose, lamotrigine should be used as the only drug (monotherapy). In combination with other antiepileptic drugs, the risk of malformations increases.

Since there is evidence that lamotrigine can disrupt the supply of folic acid to the unborn child, folic acid should be taken from the time a pregnancy is planned.

The active ingredient can pass into breast milk. Therefore, the benefits of breastfeeding should always be weighed against the risk to the infant.

Driving and using machines

The ability to react can be severely impaired by taking lamotrigine. Experts therefore recommend avoiding active participation in road traffic and operating heavy machinery, especially at the beginning of treatment.

How to get medication containing lamotrigine

Epilepsy, bipolar disorder and depression are diseases that absolutely must be treated by a doctor. In order to be able to ensure regular monitoring of the success of the therapy, drugs containing lamotrigine are only available in pharmacies in Germany, Austria and Switzerland with a doctor’s prescription.

How long has lamotrigine been known?

Lamotrigine has been available as an antiepileptic since 1993. Already at this point, its positive effects on mood and balance were noticed. Through this “side effect”, lamotrigine helps prevent depression and low spirits.

For this reason, the active ingredient is increasingly being prescribed as an antidepressant.

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