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Lamotrigine orally disintegrating tablets must remain in their original packaging. Open the package with clean dry hands before each dose. Do not try to put tablets in a pillbox if you take the orally disintegrating tablets. Lamotrigine orally disintegrating tablets will dissolve in your mouth within seconds and can be swallowed with or without liquid. Use a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take your medication.
You may also ask a family member a friend to remind you or check in with you to be sure you are taking your medication. If you miss a dose of lamotrigine, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your health care provider. Do not double your dose or take more than what is prescribed. Avoid drinking alcohol or using illegal drugs while you are taking lamotrigine. They may decrease the benefits e.
If an overdose occurs call your doctor or You may need urgent medical care. You may also contact the poison control center at A serious, life-threatening skin rash also known as Stevens—Johnson Syndrome may occur with the use of lamotrigine.
Contact your health care provider immediately if you have any of the following: a skin rash, blistering or peeling of your skin, hives, shortness of breath, or painful sores in your mouth or around your eyes. Extra caution is needed in children and teenagers ages receiving lamotrigine.
These patients may be at an increased risk of developing this life-threatening rash. Studies have found that individuals who take antiepileptic medications including lamotrigine have suicidal thoughts or behaviors up to twice as often than individuals who take placebo inactive medication. These thoughts or behaviors occurred in approximately 1 in patients taking the antiepileptic class of medications.
If you experience any thoughts or impulses to hurt yourself, you should contact your doctor immediately. Aseptic meningitis, a serious inflammation of the protective membrane that covers the brain and spinal cord has been identified as a very rare but serious side effect of lamotrigine.
Contact your health care provider immediately if you experience headache, fever, nausea, vomiting, stiff neck, rash, unusual sensitivity to light, muscle pains, chills, confusion, or drowsiness while taking lamotrigine.
Patients with certain underlying cardiac disorders or heart rhythm problems may experience serious arrhythmias or life-threatening effects. Those with structural or functional heart disease should be counseled on risk versus benefits of using this medication.
You could read the whole book and walk away with little sense that these mental illnesses are wrecking havoc on the heart, the gastrointestinal tract, the immunologic and neuroendocrine systems.
This is not how chronic diseases are approached in other medical specialties, which naturally take a long-term, disease-modifying view. You will never see a diabetes study that looks at change on a symptom check-list over 4 weeks. Or take hypertension. Clonidine lowers blood pressure right away, but most physicians prefer a thiazide for hypertension because it lowers the long-term risks of morbidity and mortality.
Individuals with bipolar disorder die 10 years earlier on average, and not from suicide. Kellie, can you read the top causes of death in bipolar disorder 10 :.
Lamotrigine is neutral on all of them, and lithium brings down most of them. Specifically, lithium lowers the risk of heart disease, stroke , cancer, viral infections, and suicide. I mean, long-term medical risks are important when considering a mood stabilizer, but we also want something that prevents the episodes. Here we have an interesting finding from studies that have compared lithium and lamotrigine. And one study did that — the LamLit trial — and confirmed that there are indeed additional benefits to combining the 2.
This does not come naturally in psychiatry. If you work in a hospital, insurance is pressuring you to get the patient better quickly, so lamotrigine is not going to be your go-to agent. In psychiatry, we treat suffering, and our patients want something that will work quickly. In practice, here is what I tell patients when starting it:. Then I talk about behavioral strategies for bipolar and depression. If you are interested in that, we have a separate podcast for patients that teaches these strategies.
Search for The Pocket Psychiatrist in your podcast store. CHRIS AIKEN: A common mistake is to stop lamotrigine when an episode returns, which is a bit like stopping blood pressure and cholesterol medications because a patient had a heart attack. You would need a before-and-after mood chart to confirm that the medication is lowering the frequency of episodes as it promises to do.
Even then the work is difficult because so many other factors can make mood better or worse. What I look for is improvement in the first 3 to 6 months after starting lamotrigine. If a patient stops it, I watch for worsening over the next 3 to 6 months. And I also listen for something that I have heard a lot of patients say on this medication, particularly those with the frequent ups and downs of cyclothymic disorder.
They see things in perspective better. Why is this medication prescribed? How should this medicine be used? Other uses for this medicine What special precautions should I follow? What special dietary instructions should I follow? What should I do if I forget a dose? What side effects can this medication cause? What should I know about storage and disposal of this medication? Brand names. Swallow the tablets and extended-release tablets whole; do not split, chew, or crush them.
Other uses for this medicine. What special precautions should I follow? Before taking lamotrigine, tell your doctor and pharmacist if you are allergic to lamotrigine, any other medications. Ask your doctor or pharmacist or check the Medication Guide for a list of the ingredients. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Talk to your doctor before you start or stop taking any of these medications while you are taking lamotrigine.
If you are taking a female hormonal medication, tell your doctor if you have any bleeding between expected menstrual periods. If you become pregnant while taking lamotrigine, call your doctor.
If you breast-feed during your treatment with lamotrigine, your baby may receive some lamotrigine in breast milk. Watch your baby closely for unusual sleepiness, interrupted breathing, or poor sucking. Do not drive a car or operate machinery until you know how this medication affects you. A small number of adults and children 5 years of age and older about 1 in people who took anticonvulsants such as lamotrigine to treat various conditions during clinical studies became suicidal during their treatment.
Some of these people developed suicidal thoughts and behavior as early as one week after they started taking the medication. There is a risk that you may experience changes in your mental health if you take an anticonvulsant medication such as lamotrigine, but there may also be a risk that you will experience changes in your mental health if your condition is not treated.
You and your doctor will decide whether the risks of taking an anticonvulsant medication are greater than the risks of not taking the medication. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: panic attacks; agitation or restlessness; new or worsening irritability, anxiety, or depression; acting on dangerous impulses; difficulty falling or staying asleep; aggressive, angry, or violent behavior; mania frenzied, abnormally excited mood ; talking or thinking about wanting to hurt yourself or end your life; withdrawing from friends and family; preoccupation with death and dying; giving away prized possessions; or any other unusual changes in behavior or mood.
Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own. Unless your doctor tells you otherwise, continue your normal diet.
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