Lamotrigine (Lamictal) & Alcohol: Is It Safe?

What Is Lamotrigine (Lamictal)?

Lamotrigine falls under the drug class of anticonvulsants, also referred to as antiepileptic drugs. It is not known exactly how it works but it is believed to function as a sodium channel blocker and exerts its main physiological effects by inhibiting the excessive release of glutamate, a neurotransmitter involved in the excitation of nerve cells.¹ By modulating sodium channels in the brain, lamotrigine may reduce the abnormal electrical activity that can trigger seizures and manic episodes in bipolar disorder.

The FDA has approved lamotrigine for two primary indications. First, it’s widely used to manage bipolar disorder symptoms, particularly in the maintenance phase of the condition. It helps to prevent or mitigate both manic and depressive episodes, acting as a mood stabilizer. Secondly, lamotrigine is used in the treatment of various seizure or epilepsy disorders.²

Patients often have lamotrigine added to their medication regimen for seizures or switch to lamotrigine when they don’t respond well to other anticonvulsants. Lamotrigine requires careful titration to avoid potentially severe skin rashes and should be prescribed and monitored by healthcare professionals.

Can You Drink Alcohol While Taking Lamotrigine?

Drinking alcohol while taking lamotrigine may be harmful and is strongly discouraged. Combining lamotrigine with alcohol can worsen lamotrigine side effects, including dizziness, drowsiness, impaired coordination, and decreased concentration. Alcohol-induced liver inflammation may also impact the liver’s ability to metabolize lamotrigine, potentially leading to elevated lamotrigine levels in the bloodstream and increasing the likelihood of experiencing side effects.

When taking lamotrigine for seizures, drinking excessive alcohol can lower your seizure threshold, making seizures more likely. Alcohol withdrawal symptoms also have this effect. Combining both substances can also slow down your breathing, lead to coma, and even death.

Individuals experiencing a manic episode while taking lamotrigine for bipolar I disorder may be more likely to engage in risky behaviors such as excessive alcohol consumption. Bipolar patients experiencing a depressive episode may also seek the mood-enhancing effects of alcohol. Alcohol directly worsens the symptoms of bipolar disorder.

How Much Alcohol Can I Drink On Lamictal?

There are no explicit prohibitions against alcohol consumption while taking lamotrigine. As a general rule, one should not exceed moderate alcohol consumption while taking Lamotrigine. Moderate drinking specifically refers to one standard drink daily for women and up to two standard drinks daily for men.

In the United States, a standard drink equals 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of distilled spirits like gin, vodka, rum, or whiskey. Individual responses to alcohol can vary, and it’s advisable to consult your healthcare provider for personalized guidance regarding alcohol use with Lamotrigine. The safest approach is to avoid alcohol consumption while taking lamotrigine.

What Are the Side Effects of Mixing Alcohol & Lamotrigine?

Alcohol has the potential to significantly intensify the central nervous system (CNS) side effects of lamotrigine.³ This includes symptoms like heightened dizziness, drowsiness, reduced concentration, lethargy, impaired judgment, coordination, and psychomotor skills.

These interactions can be particularly risky if an individual consumes excessive alcohol while on lamotrigine, potentially resulting in a dangerous suppression of the CNS, leading to severe respiratory depression, life-threatening skin reactions, and, in the most severe cases, even death.

Alcohol can also contribute to experiencing seizures or manic episodes when taking lamotrigine for these medical conditions. Limiting or abstaining from alcohol is the recommended approach. Individuals should exercise caution when engaging in activities that demand attention and alertness until they fully understand how this combination affects them.

Common side effects of mixing alcohol and lamotrigine may include:*

• Increased dizziness
• Excessive drowsiness
• Impaired concentration
• Decreased judgment
• Coordination difficulties

Severe side effects of mixing alcohol and lamotrigine may include:*

• Severe CNS depression
• Respiratory depression
• Increased risk of seizures
• Life-threatening skin rashes
• Risk of alcohol overdose
• Increased susceptibility to suicidal thoughts or behavior
• Coma
• Death

*All medications, including lamotrigine, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

How Can Alcohol Affect Bipolar Disorder?

Alcohol can significantly impact the course and symptoms of bipolar disorder, exacerbating the condition and leading to harmful outcomes. Individuals with bipolar disorder often face a heightened risk of substance abuse, with alcohol being one of the most commonly abused substances.⁴

Alcohol may initially provide a temporary sense of relief or euphoria. However, it can ultimately intensify mood swings, leading to more frequent and severe episodes of depression and mania. Moreover, alcohol can interfere with the effectiveness of prescribed medications for bipolar disorder. Medications may not work as well, and managing symptoms can become more challenging.

Excessive alcohol consumption can disrupt sleep patterns, disrupt mood regulation, and increase the risk of impulsive behavior. These can all contribute to the progression and severity of bipolar symptoms.⁵ Individuals with bipolar disorder must exercise caution and moderation when consuming alcohol. Doing so can help them effectively manage their condition and minimize its impact on their overall well-being.

When to Seek Professional Help

If you or someone you know is drinking excessively, especially if taking medications like lamotrigine, it is crucial to seek help promptly. Start by discussing your concerns with a healthcare professional, like your doctor, who can advise on the risks of alcohol use and possible interactions with lamotrigine. Bring up your concerns and explore alternative treatments that may be safer for you.

One should seek help for alcohol use when it affects personal relationships, work or school performance, physical health, or mental well-being. Signs include increasing alcohol consumption, failed attempts to cut down, neglecting responsibilities, withdrawal symptoms, and continued use despite harm awareness. Early intervention is important, so consult healthcare professionals, addiction specialists, or support groups for guidance and support in addressing these issues.

Questions to Ask Your Health Team About Lamotrigine (Lamictal) Use With Alcohol

Ask your doctor about any specific risks or complications related to alcohol and lamotrigine. Being aware of side effects, interactions, and other harmful outcomes can help you make informed health decisions regarding lamotrigine and alcohol.

Questions to ask your doctor about alcohol and lamotrigine include:

• Is there a safe amount of alcohol that I can consume with lamotrigine?
• Are there any specific side effects or interactions I should be aware of when combining the two?
• What is the impact of alcohol on the efficacy of lamotrigine?
• Is there a lamotrigine alternative that isn’t negatively affected by alcohol?
• How can I minimize the risks of adverse effects when drinking occasionally while on lamotrigine?
• What should I do if I decide to drink anyway and experience an adverse reaction?
• Should I adjust my lamotrigine dosage if I plan to consume alcohol?
• Are there any specific warning signs or symptoms that require immediate medical attention if they occur while drinking with lamotrigine?
• How frequently should I schedule follow-up appointments to monitor the combination’s effects on my health?
• Can you recommend resources or support groups for individuals managing alcohol use while on lamotrigine?

For Further Reading

• Tips on How to Stop Drinking Alcohol
• Addiction Vs. Dependence: Understanding the Differences
• Treatments for Bipolar Disorder