How does it work?

Lamotrigine is an antiepileptic medicine. It works by stabilising electrical activity in the brain. The brain and nerves are made up of many nerve cells that communicate with each other through electrical signals. These signals must be carefully regulated for the brain and nerves to function properly. When abnormally rapid and repetitive electrical signals are released in the brain, the brain becomes over-stimulated and normal function is disturbed. This results in fits or seizures. Lamotrigine prevents epileptic fits by preventing the excessive electrical activity in the brain. It does this by preventing sodium from entering nerve cells when they begin to fire rapid and repetitive electrical signals. A build up of sodium in the nerve cells is necessary for the electrical signal to build up and be passed on to other nerve cells. As lamotrigine prevents this, it helps stabilise the electrical activity in the brain. Preventing the build-up of the electrical signal also prevents the release of a neurotransmitter called glutamate from the nerve cells in the brain. Neurotransmitters are chemicals that are stored in nerve cells and are involved in transmitting messages between the nerve cells. Glutamate is a neurotransmitter that acts as a natural 'nerve-exciting' agent. It is released when electrical signals build up in nerve cells and subsequently excites more nerve cells. It is thought to play a key role in causing epileptic seizures. Reducing the release of glutamate from the nerve cells in the brain is another way in which lamotrigine helps stabilise the electrical activity in the brain and prevent epileptic fits. In addition to its licensed use for treating epilepsy, lamotrigine is used off-licence by specialists as a mood stabiliser for treating people with the psychiatric illness, bipolar affective disorder. This use is not licensed, but the medicine has been shown to be effective in people with bipolar disorder who have not responded to the traditional mood stabilisers (lithium, carbamazepine, valproate). Lamotrigine is used for treating episodes of high or low mood and for helping to prevent episodes of ill health in these people. It is not fully understood how lamotrigine works in this illness, but is thought to be to do with the reduction of glutamate in the brain.

What is it used for?

Generalised tonic-clonic seizures

Mood stabiliser in bipolar affective disorder (unlicensed use)

Partial seizures

Type of severe childhood epilepsy (Lennox-Gastaut syndrome)

Warning!

This medicine may rarely cause a decrease in the normal amounts of blood cells in the blood. For this reason, if you experience any unexplained bruising, purple spots, bleeding, sore throat, mouth ulcers, high temperature (fever), feeling tired or general illness, you should consult your doctor immediately so that blood tests can be carried out to check for this.

This medicine may reduce your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.

You should not stop taking this medicine suddenly unless your doctor tells you otherwise, as this may result in your seizures returning or getting worse. If it is decided that you should stop taking this medicine, it should be withdrawn gradually, according to the instructions given by your doctor.

The safety and efficacy of this medicine in children under two years of age has not been established by the manufacturer.

Adverse skin reactions have been reported with lamotrigine. These reactions are usually mild and self-limiting, but can on rare occasions be more serious and potentially life-threatening. When starting treatment with lamotrigine the dose is increased gradually to minimise the risk of developing such a rash. For this reason it is very important to follow the instructions you are given with this medicine, and not to exceed the prescribed dose. If you develop a rash, fever, facial swelling or swollen glands while taking this medicine you should consult your doctor immediately.

Use with caution in

Decreased liver function

Elderly people

Kidney failure

Parkinson's disease

Not to be used in

Known sensitivity or allergy to any ingredient

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

The safety of this medicine in pregnancy has not been established. It should therefore be used with caution during pregnancy, and only if the benefits to the mother outweigh any risks to the foetus. Seek medical advice from your doctor.

This medicine passes into breast milk. It should be used with caution by breastfeeding mothers, and only if the expected benefit to the mother is greater than the possible risk to the nursing infant. Seek medical advice from your doctor.

Label warnings

Do not stop taking this medication except on your doctor's advice.

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