Lamictal (Lamotrigine) Doses: Strengths, Forms, When to Use, & More

What Is Lamotrigine (Lamictal) & How Is It Used?

Lamictal is a medication that the FDA has approved for treating epilepsy.¹ This includes various types of seizures in people aged two and older.

Apart from these approved uses, doctors sometimes use Lamictal off-label to treat other conditions. Off-label refers to using a medication for a purpose not officially approved by the FDA, as determined by a healthcare provider. Lamotrigine can be used to treat acute bipolar disorder symptoms, fibromyalgia (a pain disorder), schizophrenia, and major depressive disorder.²

Lamotrigine Forms & Strengths

Lamotrigine comes in various forms and strengths, including tablets, orally disintegrating tablets, and tablets for oral suspension. The choice of form and strength depends on several factors, such as the patient’s age, the condition being treated, and individual needs.

Prescribers consider these factors when selecting the most suitable option to ensure safe and effective treatment. It’s important for patients to follow their healthcare provider’s recommendations for the specific form and strength of lamotrigine prescribed.

Lamotrigine is available in the following forms and strengths:¹

• 25 mg oral tablets
• 100 mg oral tablets
• 150 mg oral tablets
• 200 mg oral tablets
• 2 mg oral tablets for suspension
• 5 mg oral tablets for suspension
• 25 mg oral tablets for suspension
• 25 mg orally disintegrating tablets
• 50 mg orally disintegrating tablets
• 100 mg orally disintegrating tablets
• 200 mg orally disintegrating tablets

To disperse the orally disintegrating tablets, add them to a small amount of liquid, swirl until completely dissolved, and consume the entire quantity immediately. Additionally, lamotrigine orally disintegrating tablets should be placed on the tongue, where they disintegrate rapidly and can be swallowed with or without water, with or without food. Following your provider’s instructions ensures the medication’s effectiveness in managing your condition.

How to Take Lamotrigine?

To take lamotrigine (Lamictal) properly, follow your healthcare provider’s guidance. Your dose may be adjusted, so never change it on your own. Don’t suddenly stop taking it, especially if you have epilepsy, as it could trigger uncontrolled seizures. If you miss a dose, take it when you remember unless it’s close to your next dose.¹

If you accidentally take too much, seek help immediately. It might take a few weeks to feel its full effects. If you have trouble swallowing tablets, consult your healthcare provider for alternatives. Lastly, check blister packs for damage before using them, and don’t use them if the blisters are torn or missing.

Lamotrigine Dosage for Adults With Bipolar Disorder

Lamotrigine treats manic episodes in adults with bipolar disorder, and the dosage varies based on their other medications.

Here is lamotrigine dosage information for adults with manic episodes associated with bipolar disorder:

• Typical starting dosage: The typical starting dose for adults with bipolar disorder experiencing manic episodes is 25 mg daily for the first two weeks, which may be increased gradually.
• Dosage increases: Over the course of several weeks, the dosage is typically increased to a maximum of 200-400 mg daily, depending on the specific medications the patient is taking, as specified in the prescribed treatment plan.
• Maximum dosage: The maximum daily dosage of lamotrigine can vary based on individual factors and the presence of other medications. However, it usually ranges from 200 mg to 400 mg daily, with careful monitoring by a healthcare provider to ensure safety and efficacy.

Lamotrigine is primarily approved for adults as a maintenance treatment for bipolar disorder. It is used for epilepsy in individuals aged 12 and older, with dosages adjusted for younger children based on weight. Lamotrigine’s use varies based on age and condition, so discussing the treatment plan with a healthcare provider is essential.¹

Factors Affecting Lamotrigine Doses

The right dosage of lamotrigine can vary for individuals, and several factors play a role in determining the appropriate amount. These include the other medications a person might be taking, such as other anti-epilepsy drugs, which can affect the starting dose and how it’s increased. A person’s overall health, age, and how they individually respond to the medication can also influence the ideal dosage.

Certain medical conditions they might have can necessitate a different dosage strategy. Regular monitoring is essential to check how well the medication is working and if there are any side effects, which can lead to adjustments in the dosage. To ensure the effective management of epilepsy or bipolar disorder with Lamictal, it’s crucial to work closely with a healthcare provider to determine the most suitable dosage based on these factors.

What if I Miss a Dose of Lamotrigine?

If a dose of lamotrigine is missed or discontinued abruptly, it may lead to potential withdrawal effects and worsen symptoms associated with bipolar disorder or epilepsy. Some individuals may be tempted to discontinue when they start feeling better or experience initial side effects, but this can be ineffective.

Lamotrigine’s therapeutic benefits often develop gradually, and stopping suddenly can lead to symptom relapse. To ensure continued stability and symptom control, it’s crucial to maintain the prescribed regimen and communicate with a healthcare provider if considering any changes.

Lamotrigine Dosage FAQs

Many people have questions about lamotrigine dosage, and here are some commonly asked ones to provide clarity and guidance.

Here are some frequently asked questions about lamotrigine dosage:

Is 100mg of Lamotrigine a Lot?

Whether 100mg of lamotrigine is a significant dose depends on an individual’s condition and their doctor’s recommendation. For epilepsy, the usual adult dose ranges from 100mg to 700mg daily, while younger children have weight-dependent doses.

The appropriateness of 100mg should be determined by your healthcare provider, considering your specific condition, response to treatment, and other factors. It’s important to follow your doctor’s guidance on lamotrigine dosage for effective and safe treatment.

Should I Take Lamotrigine 25 mg in the Morning or at Night?

The timing of lamotrigine (25mg) can vary based on its effects on your individual sleep patterns and the prescribed dosing schedule. If the medication tends to make you drowsy, taking it at night may be more suitable, especially if you have a once-daily prescription.

On the other hand, if lamotrigine does not affect your sleep or has a stimulating effect, it’s advisable to take it in the morning. It’s important to discuss your specific situation and preferences with your healthcare provider.

How Long Does it Take for Lamotrigine to Start Working?

Lamotrigine typically starts working within hours of taking it, with peak blood levels reached between 1.4 to 4.8 hours after ingestion. The form in which you take it, such as tablets or orally disintegrating tablets, doesn’t significantly affect how it’s absorbed by the body.

This medication is rapidly and completely absorbed, with its effects beginning soon after ingestion, although the full therapeutic benefit may take several weeks to become apparent in managing conditions like bipolar disorder or epilepsy.

How Does Lamictal Make You Physically Feel?

Lamictal, or lamotrigine, can have various physical effects, but remember that individual responses vary. Common Lamictal side effects may include dizziness, tremors, headaches, and fatigue, which can impact your physical well-being.¹ Some people may experience gastrointestinal discomforts such as nausea, vomiting, diarrhea, or abdominal pain. Visual disturbances like blurred or double vision can occur.

Additionally, you might notice symptoms like fever, insomnia, or a lack of coordination. In some cases, Lamictal can cause a skin rash, which should be promptly reported to a healthcare provider. These side effects can vary in intensity and prevalence, so it’s crucial to discuss any concerns with your healthcare provider.

What Should I Do if I Develop a Skin Rash While Taking Lamictal?

If you develop a skin rash while taking Lamictal, contact your healthcare provider promptly. Although not all rashes are serious, some can be a sign of a severe and potentially life-threatening condition called Stevens-Johnson syndrome.

Your provider can assess the rash’s severity and recommend appropriate actions, which may include discontinuing the medication, adjusting the dosage, or prescribing other treatments.

Can I Suddenly Stop Taking Lamictal if My Symptoms Improve or if I Experience Side Effects?

It’s not advisable to abruptly discontinue Lamictal without consulting your healthcare provider. Sudden discontinuation can lead to symptom relapse or withdrawal effects, especially if you’re using it to manage conditions like bipolar disorder or epilepsy.

If you wish to stop taking Lamictal, work with your healthcare provider to develop a plan for gradual tapering (slowly reducing the medication) to minimize potential issues and possibly replace it with another medication.

What Should I Do if I Miss a Dose of Lamictal?

If you miss a dose of Lamictal, take it as soon as you remember. However, if it’s close to the time for your next scheduled dose, it’s generally better to skip the missed dose and continue with your regular dosing schedule.

Avoid taking two doses at the same time. Always consult with your healthcare provider for guidance if you have specific concerns or questions about missed doses.

Can You Overdose on Lamotrigine?

Yes, it is possible to overdose on lamotrigine, and it can have serious consequences. Overdosing on lamotrigine can lead to a range of symptoms and side effects, which may include lack of coordination, seizures, decreased level of consciousness, coma, and more.

Some overdose cases involving quantities up to 15 grams have been reported, and unfortunately, some of these cases have been fatal.

Signs of an overdose on lamotrigine include:¹

• Ataxia (lack of coordination)
• Nystagmus (involuntary eye movements)
• Seizures (including tonic-clonic seizures)
• Decreased level of consciousness
• Coma
• Intraventricular conduction delay (a heart rhythm abnormality)
• Nausea and vomiting
• Dizziness
• Blurred or double vision
• Irregular or slow heart rate (bradycardia)

What Should You Do If You Take Too Much Lamotrigine?

If you suspect you have taken too much Lamotrigine or experience symptoms of an overdose, it’s crucial to seek immediate medical attention. There are no specific antidotes for Lamotrigine overdose. Hospitalization might be necessary, and general supportive care is needed.

If necessary, emesis (inducing vomiting) should be considered with precautions to protect the airway. Immediate-release Lamotrigine is rapidly absorbed, and it is uncertain whether hemodialysis effectively removes it from the bloodstream. Contacting a Poison Control Center is essential for guidance on managing Lamotrigine overdosage and ensuring the most appropriate steps are taken to address the situation promptly and effectively.

Questions to Ask Your Healthcare Provider About Lamotrigine Dosage

Individuals prescribed Lamotrigine may have questions about their dosage, especially if they experience side effects or if their condition changes. It’s crucial to discuss any concerns with their healthcare provider, including their psychiatrist and therapist, to ensure the dosage aligns with their needs and any potential adjustments.

If changing prescribers is needed, online psychiatry services can be a valuable option, providing convenient access to new healthcare providers who can assess and manage medication regimens effectively, including lamotrigine dosage, while offering the flexibility of virtual consultations.

Questions to ask your care team about lamotrigine dosage include:

• How long does it typically take to adjust to lamotrigine?
• Are there potential interactions or risks if I’m already taking other anxiety or depression medications?
• What’s the optimal dosage to minimize side effects while effectively managing my condition?
• Are there specific foods, drinks, or activities I should avoid while on lamotrigine?
• Should I take lamotrigine in the morning or at night for the best results?
• How often should I expect dosage adjustments based on my progress or any side effects?
• What are the signs of potential adverse reactions or overdose, and what should I do if I experience them?
• Can I take lamotrigine with over-the-counter medications, supplements, or herbal remedies?
• What is the process for discontinuing or tapering off lamotrigine if needed?
• Are there any lifestyle changes or therapeutic considerations I should discuss with my therapist regarding this medication?
• Is it safe to use recreational drugs or alcohol with lamotrigine?
• How will my care team monitor my progress while on lamotrigine, and what should I report to them?
• Are there any potential interactions with birth control or other medications I should be aware of?
• Can I participate in activities like driving or operating heavy machinery while on this medication without risk?
• Are there any specific precautions for pregnancy or breastfeeding if applicable to me?

For Further Reading

• Bipolar Disorder Diet: Foods to Eat & Avoid – Choosing Therapy
• Lithium Side Effects: Common, Severe, Long-Term, & What to Do About Them
• What Are Bipolar Disorders?