5 Foods and Drinks to Avoid While Taking Lamotrigine (Lamictal)
Key takeaways:
It’s rare for foods or drinks to interact with lamotrigine. But it’s a good idea to avoid foods that increase your risk of developing a seizure while taking this medication.
A ketogenic diet can sometimes affect lamotrigine levels and increase the risk of having a seizure.
Certain herbs can interact with lamotrigine including ginseng, guarana, and garcinia cambogia.
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Lamotrigine (Lamictal) is a medication that can treat seizures and some conditions, like bipolar disorder. It’s important to keep lamotrigine levels in your body steady. If levels become too low, you can have a breakthrough seizure. But if levels get too high, you can experience side effects.
Most foods and drinks don’t interact with lamotrigine or affect its levels in your body. But some can worsen lamotrigine side effects and increase your risk of having a seizure. Avoiding these five foods and drinks can help keep you healthy and seizure-free while you’re taking lamotrigine.
1. Ketogenic diets
Admittedly, a ketogenic diet isn’t a food or drink, but rather a set of foods and drinks. The keto diet is low in carbohydrates and high in fat. It aims to put your body into a state called ketosis. Some children and adults with seizure disorders are started on ketogenic or specialized Atkins diets in addition to anti-seizure medications. The ketogenic diet can help people stay seizure free.
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But the modified Atkins diet isn’t compatible with all anti-seizure medications, including lamotrigine. These diets may decrease lamotrigine levels in your body. Low lamotrigine levels can trigger seizures. If you’re considering a ketogenic diet while taking lamotrigine for management of your seizures:
Talk with your neurologist before starting the diet.
Be prepared for more frequent blood checks to monitor your body’s lamotrigine levels.
Work with your neurologist to develop a plan to make sure your medication levels stay stable.
2. Alcohol
Lamotrigine can cause side effects like dizziness and sleepiness. These side effects develop because lamotrigine can slow down electrical activity in the brain.
Alcohol affects the brain and causes similar symptoms like dizziness, drowsiness, and increased sleepiness. When you combine it with lamotrigine, these side effects can become stronger. Even if you could have a drink or two without noticing side effects before, even one small drink can lead to these symptoms if you’re taking lamotrigine. This can impair your ability to make decisions and think clearly. It can also make it dangerous for you to drive or operate machinery.
It’s best to avoid alcohol altogether if you’re taking lamotrigine.
3. Dietary supplements
Many people turn to dietary supplements to support their health and wellness. But some supplements can interact with medications:
Guarana and garcinia cambogia: These supplements can lower lamotrigine levels in your body. This increases your risk for breakthrough seizures.
Ginseng: This supplement can increase lamotrigine levels in your body. Higher lamotrigine levels can lead to more serious side effects.
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Let your neurologist know if you’re taking any supplements. They can make sure it’s safe for you to take your supplements and lamotrigine at the same time.
4. Caffeine
Caffeine can affect levels of certain anti-seizure medications. Fortunately, lamotrigine isn’t one of them. But it’s still a good idea to consume caffeine in moderation if you have a history of seizures.
There’s evidence that consuming large amounts of caffeine can increase the risk of having breakthrough seizures. But that doesn’t mean you can’t enjoy a cup of coffee if you have a seizure disorder. Experts haven’t determined how much caffeine per day is “safe” for people with seizure disorders or epilepsy. The answer may be different for everyone.
The FDA recommends that adults limit their caffeine intake to less than 400 mg per day. You may want to stick with that recommendation — or even less — if you have a history of seizures. Your neurologist can also help you develop a plan to determine how much caffeine you can safely consume each day.
5. Star fruit
Star fruit (carambola) is a fruit native to Southeast Asia. It’s rich in antioxidants and has a pleasant sweet and sour taste reminiscent of citrus.
But star fruit also naturally contains a toxin called caramboxin. Caramboxin isn’t dangerous for most people. But if you have a history of kidney disease, caramboxin can trigger seizures.
It’s best to avoid star fruit if you have kidney disease and are taking lamotrigine.
The bottom line
Lamotrigine (Lamictal) is a medication that is commonly used to treat seizures and bipolar disorder. There aren’t foods or drinks that can affect how the body processes lamotrigine. But alcohol can worsen lamotrigine side effects. And certain supplements, like ginseng, can also affect lamotrigine levels in the body.
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References
Armeno, M. L., et al. (2023). Let food be thy medicine. The interaction between ketogenic diet therapy and anti-seizure medications: A systematic review. Epileptic Disorders.
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Chen, Y., et al. (2009). Effects of topiramate and other anti-glutamatergic drugs on the acute intoxicating actions of ethanol in mice: Modulation by genetic strain and stress. Neuropsychopharmacology.
Kverneland, M., et al. (2019). Pharmacokinetic interaction between modified Atkins diet and antiepileptic drugs in adults with drug-resistant epilepsy. Epilepsia.
Lakmal, K., et al. (2021). Nutritional and medicinal properties of Star fruit (Averrhoa carambola): A review. Food Science & Nutrition.
Miziak, B., et al. (2023). Caffeine and its interactions with antiseizure medications—is there a correlation between preclinical and clinical data? International Journal of Molecular Sciences.
Pedersen. S., et al. (2023). Decreased serum concentrations of antiseizure medications in children with drug resistant epilepsy following treatment with ketogenic diet. Epilepsia Open.
Tsai, M., et al. (2005). Status epilepticus induced by star fruit intoxication inpatient with chronic renal disease. Seizure.
U.S. Food and Drug Administration. (2023). Spilling the beans: How much caffeine is too much?
Ventura, S., et al. (2018). Effects of Paullinia cupana extract on lamotrigine pharmacokinetics in rats: A herb-drug interaction on the gastrointestinal tract with potential clinical impact. Food and Chemical Toxicology.
