Key takeaways:
Lamictal (lamotrigine) is a medication that treats certain types of seizures and bipolar 1 disorder.
Common Lamictal (lamotrigine) side effects include dizziness, headache, and blurry or double vision. Nausea, drowsiness, and insomnia are also possible. These side effects may improve as your body adjusts to Lamictal.
Rare but serious Lamictal side effects include severe rashes, low blood cell levels, and suicidal thoughts and behaviors. And withdrawal seizures can occur if you stop taking Lamictal abruptly on your own.
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Lamictal (lamotrigine) is a medication that treats certain types of seizures. It’s also FDA approved to treat bipolar 1 disorder.
Like all medications, Lamictal has some risks and side effects to be aware of. Some Lamictal side effects are mild and easily managed. Others are rare but can be severe.
Lamictal (lamotrigine) side effects at a glance
Here is a list of common and rare Lamictal side effects. But this is not an exhaustive list. Talk to your healthcare team about any side effects you experience while taking Lamictal, even if they aren’t listed here.
Common Lamictal side effects include:
Dizziness
Headache
Blurry or double vision
Loss of coordination
Nausea
Drowsiness
Insomnia (trouble sleeping)
Stomach pain
Diarrhea
Tremor
Cold and flu symptoms
Anxiety or irritability
Back, joint, or muscle pain
Mild skin rash
Rare but serious Lamictal side effects include:
Arrhythmias (irregular heart rhythm)
Low blood cell levels
Suicidal thoughts or behavior
Hemophagocytic lymphohistiocytosis (severe body-wide inflammation)
Meningitis (swelling of the lining of the brain and spinal cord)
Liver problems
Lamictal can cause withdrawal seizures if stopped abruptly. So you shouldn’t stop taking it on your own without a healthcare professional’s guidance.
Lamictal also has a boxed warning, the FDA’s most serious medication warning, for serious skin rashes. This side effect is rare, but it can be life-threatening without prompt treatment.
Below, we’ll discuss 11 Lamictal side effects in greater detail, including what to do if they occur.
1. Dizziness
Dizziness is one of the most common side effects of Lamictal. You may also feel clumsy or have trouble with coordination while taking it. These side effects are more common with higher doses of Lamictal. But they often improve with time as your body adjusts to it.
If you’re experiencing dizziness or clumsiness from Lamictal, take your time when sitting up or standing. It’s also a good idea to avoid driving and other activities that require coordination until you know how Lamictal affects you. This can help you avoid falls and other accidental injuries.
You should also avoid alcohol as well as other medications that can make dizziness worse. Examples include opioid pain medications and benzodiazepines, such as Xanax (alprazolam).
Know your interactions: Find out which medications interact with Lamictal (lamotrigine) and when a dosage adjustment may be needed.
Lamictal dosages: Here are common Lamictal dosages for adults along with tips on how to take it correctly.
How much does Lamictal cost? Learn more about the cost of Lamictal without insurance and how to save.
If your dizziness is severe or interfering with your daily life, tell your prescriber. They may need to reduce your Lamictal dosage or switch to a different medication for your symptoms.
2. Blurry or double vision
Lamictal side effects can include eye problems, such as double or blurry vision. You may also notice your eyes are dry and irritated in some cases. It’s less common, but Lamictal can also cause nystagmus (abnormal eye movements) in some cases.
Artificial tears can help with dry, irritated eyes. But it’s best to report any vision changes to your prescriber. In some cases, it may improve on its own. But in others, you may need a different treatment option.
3. Headache
Headaches are another common Lamictal side effect. They may improve on their own with time. And interestingly enough, Lamictal may actually help treat migraines in some people.
If you’re experiencing headaches, you might find relief from an over-the-counter pain reliever. Examples include Tylenol (acetaminophen) and Advil (ibuprofen). But ask your healthcare team first to ensure they’re a safe option for you. If headaches persist or worsen, tell your prescriber.
4. Nausea and vomiting
Some people report nausea and vomiting while taking Lamictal. Nausea seems to be more likely with higher doses. But like some other side effects, it typically goes away on its own.
You can take Lamictal with or without food. But taking it with food can help prevent nausea. Eating smaller, more frequent meals throughout the day can also help.
If your nausea continues beyond a few days after starting Lamictal, tell your prescriber. They may want to lower your dose or try a different treatment option.
5. Sleep issues
Both sleepiness and trouble sleeping are possible Lamictal side effects.
You may feel groggy or more tired than usual during the day, especially when you first start taking Lamictal. Similar to dizziness, this can make activities that require focus, such as driving, riskier. So use caution until you adjust to taking Lamictal.
Combining Lamictal with alcohol and other medications that cause drowsiness can increase the chance of this side effect. So it’s best to avoid these combinations unless your prescriber recommends them.
Some people who take Lamictal may also have trouble sleeping. In this case, focus on good sleep hygiene, such as going to bed at the same time every day and avoiding screens before bedtime. You can also ask your prescriber about the timing of your Lamictal doses to minimize sleep issues if needed.
Good to know: If drowsiness or trouble sleeping don’t improve, ask your prescriber about the possibility of switching to Lamictal XR (lamotrigine extended-release). You take this form of Lamictal only once a day. So you can take it at bedtime to minimize daytime drowsiness or in the morning to reduce insomnia.
6. Rash
Skin rashes are another Lamictal side effect. In most cases, rashes are mild. But in rare cases, rashes from Lamictal can be life-threatening and require hospitalization. And it’s hard to tell when a Lamictal rash is serious since mild rashes can become severe very quickly.
A skin rash may be the result of several different reactions to Lamictal, including:
Angioedema, which typically also causes a swollen face, lips, and tongue
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, which may also cause a high fever, swollen lymph nodes, and organ damage
Stevens-Johnson syndrome (SJS), which often appears as a blistering, painful rash with flu-like symptoms
Toxic epidermal necrolysis (TEN), which causes flu-like symptoms and a rash that covers more than 30% of your body’s surface
These rashes usually occur within 2 to 8 weeks of starting Lamictal. But a rash can occur even after you’ve been taking Lamictal for many months. They’re more common in children than adults. They’re also more common if you:
Take Lamictal with Depakene (valproic acid) or Depakote (divalproex sodium)
Take a higher Lamictal dose than recommended
Increase your Lamictal dosage too quickly
If you experience a rash while taking Lamictal — even if it seems mild — contact your prescriber immediately. If you experience symptoms such as blisters, flu-like symptoms, or trouble breathing, seek emergency medical attention.
7. Suicidal thoughts or behavior
In 2008, the FDA conducted a study on 11 anti-seizure medications (including Lamictal). The study showed that anti-seizure medications may increase the risk of suicidal thoughts and behavior. But this study grouped all anti-seizure medications together. So it’s difficult to know the true risk of this side effect with Lamictal specifically.
Still, all anti-seizure medications carry a warning for an increased risk of suicidal thoughts and behaviors. So it’s important to watch out for this. If you have unusual mood changes or feel more depressed after starting Lamictal, tell your prescriber immediately.
If you or someone you know is having thoughts of suicide, you’re not alone, and help is available. Call the 988 Suicide & Crisis Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
8. Irregular heart rhythm
Lamictal products can cause irregular heart rhythms, but this side effect isn’t common. The risk is higher if you have a history of heart problems, such as an existing arrhythmia, heart failure, or heart disease. In this case, Lamictal may not be the best medication for you.
Taking certain medications with Lamictal can also make arrhythmias more likely. Examples include other anti-seizure medications, such as Dilantin (phenytoin) and Tegretol (carbamazepine). Some heart medications can also cause this interaction, such as flecainide and propafenone.
If you have a heart condition before starting Lamictal, tell your prescriber. And make sure they know what other medications you take. They will know whether it’s safe for you to take Lamictal.
9. Low blood cell levels
In rare cases, Lamictal may lower the levels of certain blood cells in your body. This includes white blood cells, which are part of the body’s immune system. This can raise your risk of infection. It also includes platelets, which help your blood clot after an injury. This could lead to unexpected bruising or bleeding.
Sometimes, low blood cell levels may be part of DRESS syndrome. But they can happen in other cases too.
Your healthcare team will likely monitor your blood cell levels from time to time while you’re taking Lamictal in case there are any issues. But be sure to tell them if you’re getting sick more often than usual or notice any unusual bleeding or bruising.
10. Meningitis
Another rare Lamictal side effect is nonbacterial meningitis. This is a condition that causes inflammation in the lining around your brain and spinal cord. Possible symptoms include fever, nausea, and headache. You may also have a stiff neck and sensitivity to light. It can occur right after starting Lamictal, but it can also occur 1 to 2 months later.
If you’re experiencing symptoms of meningitis, tell your prescriber immediately or seek emergency care. Usually, stopping Lamictal resolves meningitis symptoms. But you shouldn’t stop taking it without a healthcare professional’s OK.
11. Withdrawal seizures
Abruptly stopping Lamictal can increase your risk of seizures. These are called withdrawal seizures. This can happen even if you’re taking Lamictal for something other than seizures.
If your prescriber recommends stopping Lamictal at any point, they’ll usually lower your dose slowly over a couple of weeks. Don’t reduce your dose more quickly than recommended. And don’t stop taking it on your own.
Frequently asked questions
No, unlike some other anti-seizure medications, Lamictal isn’t associated with weight gain in most cases. Clinical studies generally show Lamictal to be weight neutral with no effect on body weight or appetite. Some people even report a small weight loss with Lamictal. If you notice unwanted weight gain while taking it, ask your healthcare team for guidance.
Lamictal can cause anxiety in some people, but it isn’t a common side effect. And it’s more likely in those already living with anxiety before starting Lamictal or those taking multiple anti-seizure or mood-stabilizing medications. If you experience anxiety that worsens or doesn’t improve after starting Lamictal, ask your prescriber for guidance.
In rare cases, Lamictal may cause liver injury. This can range from a mild increase of liver enzymes (proteins) to severe liver failure. Experts estimate liver injury is rare, and it’s usually reversed within a few days of stopping Lamictal. Liver injury may also happen as part of a severe reaction to Lamictal, such as DRESS or TEN. If you experience signs of drug-induced liver injury, tell your prescriber. These can include stomach pain, dark urine, and jaundice (yellowing of the skin and eyes).
No, unlike some other anti-seizure medications, Lamictal isn’t associated with weight gain in most cases. Clinical studies generally show Lamictal to be weight neutral with no effect on body weight or appetite. Some people even report a small weight loss with Lamictal. If you notice unwanted weight gain while taking it, ask your healthcare team for guidance.
Lamictal can cause anxiety in some people, but it isn’t a common side effect. And it’s more likely in those already living with anxiety before starting Lamictal or those taking multiple anti-seizure or mood-stabilizing medications. If you experience anxiety that worsens or doesn’t improve after starting Lamictal, ask your prescriber for guidance.
In rare cases, Lamictal may cause liver injury. This can range from a mild increase of liver enzymes (proteins) to severe liver failure. Experts estimate liver injury is rare, and it’s usually reversed within a few days of stopping Lamictal. Liver injury may also happen as part of a severe reaction to Lamictal, such as DRESS or TEN. If you experience signs of drug-induced liver injury, tell your prescriber. These can include stomach pain, dark urine, and jaundice (yellowing of the skin and eyes).
The bottom line
Lamictal (lamotrigine) treats certain types of seizures and bipolar 1 disorder. Common Lamictal side effects include dizziness, blurry or double vision, and headache. Sleepiness and nausea may also occur. These side effects may improve as your body adjusts to Lamictal.
Rare but serious Lamictal side effects include severe rashes, irregular heart rhythms, and suicidal thoughts or behavior. Rarely, meningitis and low blood cell counts may occur.
Abruptly stopping Lamictal may cause withdrawal seizures. So if you’re experiencing side effects, ask your prescriber for guidance. Seek emergency care for any Lamictal side effects that seem severe or life-threatening.
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