Lamotragine?

One of the medications my doctors are looking at to treat BPII is lamotragine, but I've just looked it up in the BNF and it's listed for use in controlling epileptic seizures, NOT for managing mood disorders.  Do you think this is an off-label use, or anything I should worry about?

Has anyone had experience of using it?

[SurfRake]

I have used this drug for BP1 for five years, and it's been the best drug for controlling mood swings that I've used, especially and unexpectedly establishing a "floor" that prevents/lessens depression periods I'd formerly experienced more frequently and strongly.  

Lamictal for me does well to moderate mood swings, esp. now that I take 300 mg combined with 600 mg of Trileptal, but the latter, also developed as an anti-seizure med, makes me groggy and spaced-out. I began to take both after a year of taking only Lamictal b/c tremendous stressful events took place in 2006, and I've stayed with that regimen.

A decent resource, with some extreme opinions, is http://www.askapatient.com/viewrating.asp?drug=20241&name=lamictal

Side effects for me have been accelerated hair loss, more intense dreams and some night sweats.

[dame_wilbur]

Lamictal works wonderfully to stabilize my moods, and is, to my understanding, very commonly used for mood disorders. My psych has had me on it for years, and works in colaboration with my neuro so that I get double work out of it as it also works as a migraine medication. I take 150mg tabs 2x/day. Any time we try to drop back on my dose, I immediately get more unstable and we have to quickly up the dose again.

I've found that anticonvulsants in general have *many* uses outside of the siezure prevention/control. My understanding is that it's because the drugs like Lamictal work on the chemicals in the brain that perform many differnet tasks.

I think I did gain some weight when I initially went on the Lamictal, although I'm not positive, as that was *many* years ago. However, the benefits I reap from taking it far out weigh any side effects.

I'm confused that SurfRake said that their dreams got more vivid, as I haven't had a dream (or at least one I can remember) since I started taking it close to 9 years ago. That's fine by me as I used to get horrible night terrors triggered by my migraines where I would wake up bashing my head against the wall. So when the Lamictal took away the night terrors, I was thrilled. Maybe it works differently for different people?

Good luck and keep us posted,

~Dame

[moonpanda]

Lamotrigine and some other anti-convulsant medications are approved for maintenance treatment in bipolar I disorder, because they have something to do with altering the excitability threshold of certain neurons. We're not yet entirely sure how that helps to control mood instability in bipolar disorder, but they are proven to be very effective in this regard. The good thing about lamotrigine in particular is that it can also have an  anti-depressant on top of the mood stabilization!

I'm currently on Lamictal (lamotrigine). It is technically off-label use in bipolar II, because it's approved for BP I. However, it's really commonly used in BP II because of the antidepressant effect, and because individuals with BP II are often more likely to experience more frequent depressions and fewer manias.

Also, I know what SurfRake means about more vivid dreams; my dreams are EPIC. It's kind of awesome. I usually remember my dreams every night, and these ones are particularly cinematic. They might soon inspire me to write some H.P.Lovecraftian short stories in the future.

So far, I haven't had too many other side effects. I do sometimes feel "flu like symptoms" when my dose is changed, but that eventually goes away after my body readjusts. The one drawback about lamotrigine is that it needs to be titrated up very, very slowly (your doctor probably explained this to you), because of the risk of developing a serious and potentially fatal rash. This risk is not common, but erring on the safe side, the doses are increased very slowly. Because of this, it takes a while to reach a therapeutic dose, and this why it's used as a maintenance treatment rather than as a treatment for acute episodes.

From what I've heard and read, it really is a great med (I'm reserving personal judgment until I get to that therapeutic dose myself). I was on lithium before this, and while it actually worked quite well to even me out and to put off any big mood episode, once that big mood episode emerged, triggered by way too many terrible life stressors finally taking their toll, I overdosed on it. After having it completely flushed from my system in hospital, I just couldn't stomach taking it anymore, and I stopped taking it myself without telling anyone (not a recommended course of action).

I would say to give it a try if they think it might help with your particular case! Let us know what you decide!

[adel_ezz]

lamotrigine/lamictal is the best inn my view.

[bessy88]

Hello Ive only been on it for about 2 weeks now and I haven't noticed any side effects except for horrible dreams but I will let you know how I go when my dosage gets higher.

[danni35]

I have been on lamotrigine for just over a year, my vivid dreams can be very scary. They have started in the last 6 weeks. My doctor says that I am most likely having episodes of delirium. I have had to get tests done to find out, still waiting for the results. I also may be having absence seizures, for me this has been very hard as I thought that for me I had finally found the right medication. But it may not be. So I guess everyone does reacts differently. Hopefully for me they need to decrease the dose and that will help, because this otherwise has worked really well for me.