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Lamictal Withdrawal Help, Lamotrigine Side Effects, Symptoms, Treatment

Lamictal Withdrawal Help, Lamotrigine Side Effects, Symptoms, Treatment

This entry was posted in Antipsychotic on by .

Last Updated on March 2, 2021 by Carol Gillette

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Alternative to Meds Editorial Team
Written by Diane Ridaeus Published Sep 13, 2018
Medically Reviewed by Dr John Motl MD

Medical professionals typically do not possess the expertise necessary to navigate Lamictal withdrawal. While they may be prone to getting people inducted on powerful neuroleptic medications, they rarely feel equipped to getting them off.

Even if Lamictal was prescribed during a demonstrable crisis, this does not always mean that a lifetime of drug use is warranted.

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Lamictal Withdrawal Symptoms (Lamotrigine Withdrawal)

Lamictal withdrawals can be mild, moderate, or severe and medical oversight is recommended to anyone considering withdrawal from the medication. If the withdrawal is too sudden, some people have reported seizures and seizures of greater intensity and frequency where withdrawal is too rapid.6 Gradual cessation is the recommended way to come off Lamictal. Some people will have little to no withdrawal symptomology, some may have much more severe discomfort.

Lamictal withdrawal symptoms include:

  • Seizures, increased frequency and duration of seizures *
  • Changes in mood, temperament
  • Suicidality
  • Lethargy
  • Headaches
  • Unusual sensations, i.e., prickling or tingling
  • Tiredness

*In a 2005 study comparing withdrawal manifestations off Lamictal and other anticonvulsants, all participants experienced seizures of increased intensity during withdrawal.6

Lamictal (lamotrigine) is an anticonvulsive medication used in the treatment of seizures in patients aged two years and up, and as maintenance for the delay of recurring episodes of depression, mania, and hypomania to help patients suffering from bipolar disorder.

Below you will find a number of topics for discussion and study, including uses for the drug, side effects, notes about withdrawals, and other frequently searched topics of information about Lamictal. There are some special safety notes and warnings that anyone considering starting or stopping Lamictal (lamotrigine) should be aware of.

What Lamictal (Lamotrigine) is Used For

Lamictal is used for epileptic seizure prevention and control, and to treat the manic and depressive episodes of adult bipolar disorder.

It is approved for use in children as young as 2 years old as an anticonvulsant medication to prevent epileptic seizures.

Lamictal Alternative Names and Slang (Lamotrigine)

Lamictal is the brand or trade name for the generic drug lamotrigine. There is no known slang or street name for the drug, and there is no evidence that the drug has been associated with street or illicit use or sale. There are many alternate names for Lamictal, including domestically:

  • Lamotrigina
  • Lamotriginum
  • 3,5-Diamino-6-(2,3-dichlorophenyl)-1,2,4-triazine

And just some of the international names include:

  • Elmendos
  • Labileno
  • Lambipol
  • Lamictal CD
  • Lamictin
  • Lamotrix
  • Mogine

Lamictal (Lamotrigine) Side Effects

lamictal side effectsIn April 2018 the FDA issued a new warning regarding anti-seizure medications including Lamictal precipitating a rare but life-threatening reaction. This reaction is described as a severe immune system inflammation, called HLH or hemophagocytic lymphohistiocytosis which can quickly escalate, especially if not treated quickly, and can lead to death.

Some signs of HLH include persistent fever and low or absent natural killer cells, and certain other characteristics in the blood that are markers for HLH. Mortality rates for HLH are 50%, and it occurs in children more often than in adults, which is a concern since Lamictal is approved for patients aged two years of age and older.1

Severe Lamictal Side Effects:

  • Kidney failure
  • Severe rash
  • Stevens-Johnson syndrome (life-threatening ulcers, eruptions, blistering, peeling, open sores, and discolorations of the skin with other complications involving the mucous membranes or other areas, requiring immediate cessation and emergency treatment in ICU or burn unit)
  • Impaired liver function
  • Anemia (low red blood cell count)
  • Loss of hearing
  • Dyskinesia (an involuntary movement disorder)
  • Hives
  • Tumor in breast tissue
  • Blood disorders
  • Decreased white blood cells
  • Decreased blood platelets
  • Meningitis (inflammation of the brain, rigidity, intense fever, and pain, can lead to coma or death)
  • Epididymitis (infection/inflammation of the testicles)
  • DRESS syndrome (severe rash, hypersensitivity event, that has a 10% mortality rate)
  • Hypersensitivity drug reaction (allergic-type reaction to a drug)
  • Erythema Multiforme (mucous membrane/skin reaction can be mild or can be life-threatening in rare cases)
  • Lowered resistance to infection
  • Purplish spots on the skin
  • Stopped breathing
  • Pancreatitis
  • Multiple organ failure
  • Repeating seizures, loss of consciousness between episodes
  • Toxic epidermal necrolysis (similar to Stevens-Johnson syndrome, the skin falls away, leads to sepsis, and requires emergency treatment)
  • Vasculitis (inflammation of the blood vessels)

Common Lamictal Side Effects:

  • Tremors
  • Suicidality
  • Altered mental states
  • Mood swings
  • Anxiety
  • Confusion
  • Joint pain
  • Loss of appetite
  • Weight changes
  • Painful menstruation
  • Neck pain
  • Involuntary eye movements
  • Irritable, easily upset or angered
  • Worsening depression
  • Shakiness
  • Loss of coordination
  • Dizziness
  • Somnolence
  • Headache
  • Nausea
  • Pain in stomach
  • Back pain
  • Insomnia
  • Flu-like symptoms such as sore throat, runny nose, nasal inflammation, etc.
  • Double vision or blurring of the vision
  • Dry mouth
  • Rash
  • Chest pain
  • Tiredness, fatigue
  • Sensitivity to light
  • Swelling of the hands, feet, limbs
  • Stiff neck
  • Fainting, losing consciousness

It should be noted that since many very young children are placed on Lamictal for epilepsy disorders, careful monitoring should be on-going for any signs of these or other unusual or adverse reactions to this drug.

Getting Off Lamictal (Lamotrigine) Gradually

Lamictal should never be stopped abruptly, unless as in the case of HLH, or Stevens-Johnson syndrome, or other dire situations as noted above, where there is a medical emergency that requires such measures as a life-saving maneuver. These require immediate hospitalization.

In the vast majority of cases, a gradual taper is the recommended procedure for coming off a mood stabilizer to avoid a sudden shock to the body that could leave the person in a worse off state than before the prescription was initiated.

Lamictal influences two amino acids, aspartate and glutamate. These are excitatory neurotransmitters, which Lamictal restricts the release of, thereby causing a calming effect. When gradual Lamictal tapering is occurring, more of these excitatory agents may start to release into the system and this may cause rebound excitability.

Lamictal restricts presynaptic permeability of the excitatory amino acids aspartate and glutamate. When a person is withdrawing from the medication, it is generally accepted that more of these excitatory amino acids, with stimulatory neuromodulating capabilities, will begin to flood into the synapse, and there may be rebound excitability. Aspartic acid and glutamic acid are the acidic versions of aspartate and glutamate. This can be further compounded if foods containing versions of aspartate and glutamate are consumed during the withdrawal period. Therefore, foods such as diet sodas, processed foods, and artificial sweeteners (which break down into aspartate) should be restricted. One can do a search for foods that contain aspartate and glutamate to be sure these can be avoided. This modified diet may help significantly during Lamictal withdrawal.

Lamictal Withdrawal (Lamotrigine) FAQs

Information has been collected here covering some often asked questions about the drug’s classification, its properties, how it is used in treatments, and several other topics.

Is Lamictal a Mood Stabilizer?

Lamictal was approved by the FDA as a mood-stabilizing medication and is considered highly effective in preventing episodes of depression in patients with bipolar disorder. It is most often used for its anticonvulsant properties to prevent epileptic seizures in children and adults. Approximately 6 out of every 1000 people in the US suffer from seizure disorders.

Epileptic seizures occur when too many electrical signals are firing at one time in the brain and central nervous system. The seizure could be likened to a “short circuit.” 4

It is thought that Lamictal (lamotrigine) stabilizes electrical activity in the brain. Preventing too much electrical activity also stops or curbs the release of a neurotransmitter called glutamate. Glutamate is the most abundant amino acid in the brain and throughout the entire central nervous system. Glutamate is also the most powerful excitatory neurotransmitter in the human body and brain.2

Along with inhibiting the release of glutamate, Lamictal is also thought to signal the release of GABA, an inhibitory neurotransmitter.

By influencing and perhaps modulating the interchange of these two neurotransmitters it is hypothesized that Lamictal can stabilize moods, prevent seizures, and prevent bipolar episodes or depression or mania from happening.3

Is Lamictal Used for Depression?

Yes, Lamictal is used in bipolar patients to prevent or delay depressive episodes, as well as to prevent or delay manic or hypomanic episodes in bipolar patients. There are reports of the drug being used for depression where other antidepressant medications have not helped.

Can Lamictal Cause Liver Damage?

Yes, Lamictal has been linked with liver damage and liver failure. A patient taking Lamictal should be monitored and checked regularly for any signs of liver pathology or damage.

Treatment for Lamictal (Lamotrigine) Abuse and Addiction?

Lamictal dependence can occur over time, as with any medication. There is a lot yet to be learned about how Lamictal and similar drugs work, but it is known that the body can build up a tolerance to a drug, and that side effects can become problematic.

The decision to come off Lamictal should be carefully assessed in the context of why it was prescribed, and whether the drug has or has not increased the health and quality of life of an individual.

Because of the inherent risks involved with Lamictal, withdrawal should only be done under medical supervision so that the process can be done in a safe and controlled way.

When choosing help, be sure to ask if the professionals who you will be working with have specific experience working with patients coming off Lamictal, and medication withdrawal in general.

In addition to the above discussions with your physician, don’t be afraid to ask about the complications that the doctor has personally seen, and how they might have been resolved. Certainly, if he or she has been doing medication withdrawal and has attained competence, there would have been some rough cases along the way. Sometimes, certain cases would like outside of outpatient capacity to treat. Knowing the difference is mastery and sometimes a second opinion is pragmatic.

The prescribing doctor may be reluctant to withdraw a medication that they have invested faith into. A doctor that specializes in medication withdrawal may have unique viewpoints worth considering.

These questions would probably be even more important to explore primarily if outpatient treatment is being considered. Antipsychotic medication withdrawal complications may sometimes fall outside the capacity of an outpatient treatment setting. Seek second opinions, and keep asking questions until all the information you need has been provided so a confident treatment decision can be made.

getting off lamictalIf mental health issues, for example, depression or the beginning signs of mania, were not met with holistic, medical or other drug-free exploratory methods and investigations before prescribing medication, then no real attempt to discover why these symptoms were present ever occurred. Holistic psychiatry would incline toward such investigative work well before prescribing medications.5

An inpatient program that does implement investigative testing might be a considered approach leading to bonafide solutions that do not have to include prescription drugs.

Alternative to Meds Center does offer such investigatory work as part of the usual programs, as well as safe Lamictal tapering methods administered by physicians with decades of experience in medication withdrawal. We encourage anyone in this difficult situation to become more acquainted with our resources for safe and gentle Lamictal withdrawal.

1. “FDA Drug Safety Podcast: FDA warns of serious immune system reaction with seizure and mental health medicine lamotrigine (Lamictal)” US Food & Drug Administration, last updated 2018 Apr 30 [cited 2020 Dec 17]

2. Zhou Y, Danbolt NC “Glutamate as a neurotransmitter in the healthy brain” Journal of Neurotransmission, NCBI [INTERNET] 2014 Mar 1 [cited 2020 Dec 17]

3. Cunningham MO, Jones RS “The anticonvulsant, lamotrigine decreases spontaneous glutamate release but increases spontaneous GABA release in the rat entorhinal cortex in vitro” abstract, PubMed, 2000 Aug 23 [cited 2020 Dec 17]

4. “BAM! Body and Mind” Centers for Disease Control, Reviewed Oct 2014 [cited 2020 Dec 17]

5. Gibbs G DO “What is Holistic Psychiatry?” MadInAmerica, 2016 Dec 3 [cited 2020 Dec 17]

6. Wang-Tilz Y, Tilz C, Wang B, Pauli E, Koebnick C, Stefan H. “Changes of seizures activity during rapid withdrawal of lamotrigine.” Eur J Neurol. 2005 Apr;12(4):280-8. doi: 10.1111/j.1468-1331.2004.01101.x. PMID: 15804245.[cited 2020 Dec 17]

This content has been reviewed and approved by a licensed physician.

Dr. John Motl, M.D.

Dr. Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona.  He holds a Bachelor of Science degree with a major in biology and minors in chemistry and philosophy. He graduated from Creighton University School of Medicine with a Doctor of Medicine.  Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.

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