Lamotrigine: Uses and Side Effects

Lamotrigine is an anticonvulsant medicine used to treat epilepsy. in patients older than 2 years. However, its use for the management of seizures is only approved for those over the age of 16.

This drug is also used as a maintenance treatment in adults with bipolar disorder. In some cases, lamotrigine is used for the management of neuropathic pain and depression.

It comes in tablets to swallow, sublingual, chewable, or extended-release tablets. The Food and Drug Administration (FDA) has warned of potential major side effects. We will talk about it below.

What to consider before taking lamotrigine?

Available data indicate that about 10% of those who take lamotrigine experience an adverse reaction. In a small percentage, that reaction can be fatal.

Before taking Lamotrigine it is necessary to inform the doctor about the following points:

  • Other medications: inform about any other drug being consumed, which includes nutritional supplements, vitamins and any naturopathic products.
  • Female hormonal drugs: the use of female contraceptives or any hormonal therapy should also be reported.
  • History of autoimmune disease: if you have had an allergic reaction to any other active ingredient in the past.
  • Pregnancy or breastfeeding: a pregnant woman or who thinks she is it must indicate it to the doctor.

On the other hand, it should be taken into account that lamotrigine can cause drowsiness or dizziness. Therefore, those who carry out activities that require maximum attention should take it into account.

The use of lamotrigine for epilepsy is supported, although the associated risks and adverse effects must be considered.

Keep reading: How to understand a drug's package insert?

Common side effects

The most common side effects of lamotrigine are headache and skin rash.. They occur in 1 in 10 patients. It is also common for the following manifestations to appear:

  • Sleepiness or drowsiness
  • Dizziness, tremors, or spasms
  • Insomnia.
  • Diarrhea, nausea, or vomiting
  • Tiredness and muscle or joint pain.
  • Irritability, aggressiveness and agitation.

In rare cases more serious reactions arise, such as Stevens-Johnson syndrome, DRESS syndrome, toxic epidermal necrolysis, disseminated intravascular coagulation, hemophagocytic lymphohistiocytosis (HLH) and other abnormalities in the blood.

You may also be interested in: Immune response: everything you need to know

Lamotrigine Rash Warning

One of the most disturbing side effects of lamotrigine is a rash. This is an allergic reaction that can turn into a hospital emergency. In some cases it causes permanent disability.

This reaction is called hemophagocytic lymphohistiocytosis (HLH) and constitutes an uncontrolled response of the immune system. Children 2 to 17 years of age who take lamotrigine and who combine it with other drugs are at higher risk of developing it.

It usually occurs in the first 2 to 8 weeks of treatment, but it can appear at any time. The rash could also be a symptom of more complex problems, such as Stevens-Johnson syndrome or toxic epidermal necrolysis.

Main symptoms

Symptoms of a mild lamotrigine rash include hives, swelling, and itchy skin.. If it is a severe case, more severe manifestations may appear, such as swelling of the face, lips and tongue, as well as difficulty swallowing or breathing. It is sometimes associated with fever, nausea and vomiting, unusual bruising or bleeding, jaundice (yellowing of the eyes and skin).

Other symptoms may indicate the presence of Stevens-Johnson syndrome, which should be suspected with purple blisters, cough, and signs of the flu. For its part, DRESS syndrome is characterized by the exaggerated production of white blood cells, which is detected in a biochemical analysis.

Why can a reaction to lamotrigine occur?

Lamotrigine rash is due to drug hypersensitivity. It can appear immediately after ingesting it or several days or weeks later. There are some factors that imply a greater risk and they are the following:

  • Age: those under 17 are more likely.
  • Co-medication: take lamotrigine if you take other medicines, especially if they are anticonvulsants.
  • High starting dose: with rapid increase in milligrams.
  • History of allergic reactions: especially when the reaction occurred against an anticonvulsant.
  • Genetics: there are genetic factors that make the adverse reaction more predictable.
  • Wrong use: alter the prescribed doses, eat them after hours or suspend and restart the intake.

Dermal reactions to lamotrigine range from mild dermatitis to severe skin problems.

Diagnosis and treatments

If any of the symptoms of an adverse reaction occur, it is indicated to suspend the medication and consult with the doctor. When the rash appears there is no way of knowing if it is going to get worse or not.

The doctor will do an interview and a clinical examination. He may also order some tests to check for other damage.

Treatment will depend on the severity of the reaction.. Corticosteroids or antihistamines may be prescribed to control the reaction. If it is serious, hospitalization will be necessary.

Prevention of lamotrigine reactions

The best preventive measure is to tell your doctor about any other drugs you are taking. Also update you on a history of allergies or autoimmune disease.

It is very important to follow the instructions for the doses to be ingested. Likewise, it is advisable to observe the exact frequency of ingestion and be attentive to any mild adverse reaction that could continue with a cascade of associated symptoms.

You must attend all medical appointments and take all the exams that the professional orders. Sometimes it is necessary to evaluate the response to the drug using laboratory tests.