Can Lamictal be used for anxiety?

This article will answer the question of whether Lamictal can be used for anxiety.

We will also discuss what Lamictal is, what it is used for, side effects, and precautions to be taken for the use of this drug. 

Can Lamictal be used for anxiety?

The answer to the question of whether Lamictal or Lamotrigine can be used for anxiety is- officially no because the FDA has approved the use of Lamotrigine for the treatment of only two disorders- Epilepsy and Bipolar disorder, in the place of lithium and valproate. 

However, there have been a few studies that have been done on the application of lamictal or lamotrigine for the treatment of other mental disorders- for this blog, specifically anxiety disorders but these studies do not give conclusive evidence.

In 2008, a study was done to understand whether lamotrigine could be used to treat anxiety in individuals with bipolar disorders in addition to lithium. 

The participants, 22 of them, were individuals who were on remission from bipolar disorder episodes and currently taking lithium for maintenance however they have current anxiety disorder. 

The group was given lamotrigine for 12 weeks and the results showed that it was effective in treating individuals who had anxiety comorbid with bipolar disorder. However, it was not as effective as another drug that was also used in the trial. 

Let us consider this 2011 study that was done to understand the effect of  Lamotrigine treatment for individuals affected by epilepsy and anxiety disorder. The researchers put forward the observation that epilepsy is often comorbid with mental disorders and most frequent ones being anxiety, depression, panic attacks, as well as psychosis in some cases. 

So they set out to study whether lamotrigine, an effective treatment for epilepsy, can also benefit other mental disorders or symptoms of mental disorders. The researchers found that this particular medication was an effective treatment for mood disorders which might include anxiety.

Most of the studies on Lamotrigine or Lamictal on anxiety do not bring about conclusive evidence that the drug is effective for the treatment of anxiety disorders alone, since most of the studies involve comorbid anxiety disorder. 

However a review dated to the year 2007, analysed the evidence of Anticonvulsant drugs for the treatment of anxiety disorder and though it was stated that these drugs are effective in treating mood disorder like depression and bipolar, the review sought out to understand the effect of these drugs on anxiety. 

According to the review, it was found that lamotrigine did have some impact on posttraumatic stress disorder  and this was also echoed in a recent case study published in the year 2021 that explored the effects of Lamotrigine on PTSD amidst the 2019 pandemic.  The researchers concluded that 

“…LTG is a potentially efficacious therapeutic approach in patients with PTSD…” (Pham TL, Chrousos GP, Merkenschlager A, Petrowski K, Ullmann E, 2021).

While this could lead to potentially more studies to understand how the drug can be used to treat anxiety related to PTSD, this particular case study is not enough to say with conviction that Lamotrigine can be used for anxiety. 

What is Lamictal?

Lamictal is the brand name for the drug lamotrigine which is a class of drug called anticonvulsant which is used as an anti-epileptic medication.

Lamictal is used either alone or with other medications to treat epilepsy, particularly to treat the epileptic seizures in both adults and children. 

The FDA has also approved the use of Lamictal for the maintenance and delay of mood episodes for individuals diagnosed with Bipolar disorders. 

The various forms of the drug are available where the Immediate-release Lamictal can be used in children as young as 2 years old for seizure treatment with other medications but not alone for anyone younger than 16 Whereas the extended release forms has only been approved for adults and children older than 13. 

What is Lamictal used for?

Lamictal is an anticonvulsant  that has been FDA approved for the treatment of two disorders: Epilepsy and Bipolar disorder (used in place of lithium and valproate)

Lamictal tablets in all forms are used alone, by itself, for the treatment of Epilepsy and Lennox-Gastaut syndrome, whereas the extended release form could be used with other medications. 

All forms of lamictal, other than the extended release form, are also used to treat or delay the onset of depressive, manic, and abnormal moods episodes in bipolar disorder. However,it must be mentioned that the drug is only effective for maintenance and not to stop an active episode. 

What are the side effects of Lamictal?

Here are some side effects caused by Lamictal:

  • loss of balance or coordination
  • double vision
  • blurred vision
  • uncontrollable movements of the eyes
  • difficulty thinking or concentrating
  • difficulty speaking
  • headache
  • drowsiness
  • dizziness
  • diarrhoea
  • constipation
  • loss of appetite
  • weight loss
  • heartburn
  • nausea
  • vomiting
  • dry mouth
  • stomach, back, or joint pain
  • missed or painful menstrual periods
  • swelling, itching, or irritation of the vagina
  • uncontrollable shaking of a part of the body (Medlineplus)

These side effects can range from serious to mild. Mild side effects can disappear on their own; however , if any of these side effects impact your daily life, let your doctor know.

Serious side effects that require immediate medical care include:

  • swelling of the face, throat, tongue, lips, and eyes, difficulty swallowing or breathing, hoarseness
  • seizures that happen more often, last longer, or are different than the seizures you had in the past
  • headache, fever, nausea, vomiting, stiff neck, sensitivity to light, chills, confusion, muscle pain, drowsiness
  • unusual bleeding or bruising
  • fever, rash, swollen lymph nodes, yellowing of the skin or eyes, abdominal pain, painful or bloody urination, chest pain, muscle weakness or pain, unusual bleeding or bruising, seizures, trouble walking, difficulty seeing or other vision problems
  • sore throat, fever, chills, coughing, difficulty breathing, ear pain, pink eye, frequent or painful urination, or other signs of infection
  • racing heartbeat, skipped or slow heartbeat, shortness of breath, dizziness, or fainting (MedlinePlus)

How to use lamictal?

When it comes to the use of this drug, lamictal or lamotrigine the best thing you can do is to follow your doctor’s advice and orders carefully with respect to the dosage, the timings, and the routine of the drug intake.

Usually, the drug is taken once or twice daily with or without food and the dosage starts low from 25mg which is gradually increased upto 400 mg if needed over a span of weeks. 

When it comes to taking the drug it is advised that you do not chew or crush the drug and instead swallow whole for the extended release form of lamictal. This form is taken only once a day. 

It is also advised that you keep the drugs in the original tablet packaging and not to move it to a pill box, especially in the case of the disintegrating tablet form of lamictal. 

If you are taking the chewable dispersible tablets, you can chew them or dissolve them in a liquid while taking the drug in this form. 

Make sure that you take the medication at the same time everyday and for this you can use an alarm, a reminder etc to remind you to take the medication at the right time. You can also ask for assistance from a friend or caregiver to help you remember your dosages. 

If you are switching medications, make sure that you and your doctor come up with a plan to carefully and gradually taper you off from the old medication and gradually increase your dose for lamictal. 

If you miss a dosage, take it as soon as you remember it, however do not take it if you are close to the next dosage so as to avoid double dosing. If you miss more than 3 days of medication, let your doctor know immediately. 

Even if you feel like the drug is making you feel better, usually happens after a few weeks, do not stop the drug intake as well as in the case of experiencing mild side effects as these mild effects will soon go away on their own over time.

What are the precautions one should know when using lamictal?

Here are a few precautionary steps you should take if you are taking or being prescribed with Lamictal:

Inform your doctor if you are allergic to Lamotrigine or any other medications that have this ingredient and make sure to check the ingredient list of the medication for any allergens. 

Inform your doctor if you are taking any other prescription or non-prescription medication, supplements, and vitamins. This is very important because lamictal can react with other medications. 

Let your doctor also know if you are taking any hormonal medications including contraceptives in every form- tablets, rings, patches etc or if you have been part of any hormone replacement therapies. 

Let your doctor know you entire medical history while highlighting if you have had any of the following disorders:

  • Autoimmune disease
  • Blood disorder
  • Depression and other mood related disorders
  • Heart disease
  • Liver disease
  • Kidney disease
  • Heart failure
  • Ascites.

Tell your doctor of any plans to get pregnant or if you are already pregnant as well as if you are breastfeeding or planning to breastfeed your child since the medication can transfer from mother to child through milk, and Lamotrigine has been associated with an increased risk of oral cleft birth defects.

Make sure that if you are taking medication that you do not drive or use heavy machinery or do anything that is prone to accidents because the drug can make you drowsy. 

One of the side effects of this drug is the fact that it does affect you mental health and you might develop suicidal ideation, so make sure that you and your doctor understand this risk and keep track of your mental health and report the same to your doctors or your caregiver in case you see any changes. 

Conclusion

This article answered the question of whether Lamictal can be used for anxiety.

We also discussed what Lamictal is, what it is used for, side effects, and precautions to be taken for the use of this drug. 

How long does Lamictal take to work for Epilepsy?

It usually takes around 6 weeks for lamotrigine to work properly and for individuals to see positive results. .

Does Lamictal calm you down?

Lamotrigine can calm you down as it is the only mood stabiliser that calms mood swings by lifting the depression and preventing it. 

Does Lamictal help with obsessive thoughts?

Research has found that Lamictal or Lamotrigine was effective in reducing obsessive-compulsive symptoms along with depressive symptoms

How does Lamictal make you feel?

Lamotrigine may make you feel calmer, drowsy and sleepy.

What mental health disorders does Lamictal help with?

Lamictal is approved by the FDA for the maintenance treatment of symptoms related to depression, mania, hypomania (a milder form of mania), and mixed episodes 

References

Lamotrigine. Drugs.com. Retrieved on 5th February 2022. https://www.drugs.com/monograph/lamotrigine.html

Lamictal. Drugs.com. Retrieved on 5th February 2022. https://www.drugs.com/lamictal.html

Lamotrigine (Lamictal). National Alliance on Mental Illness. Retrieved on 5th February 2022. https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Lamotrigine-(Lamictal)

Lamotrigine. Medlineplus. Retrieved on 5th February 2022. https://medlineplus.gov/druginfo/meds/a695007.html

Sepić-Grahovac D, Grahovac T, Ružić-Baršić A, Ružić K, Dadić-Hero E. Lamotrigine treatment of a patient affected by epilepsy and anxiety disorder. Psychiatr Danub. 2011 Mar;23(1):111-3. PMID: 21448112.

Maina G, Albert U, Rosso G, Bogetto F. Olanzapine or lamotrigine addition to lithium in remitted bipolar disorder patients with anxiety disorder comorbidity: a randomized, single-blind, pilot study. J Clin Psychiatry. 2008 Apr;69(4):609-16. doi: 10.4088/jcp.v69n0413. PMID: 18294024.

Mula M, Pini S, Cassano GB. The role of anticonvulsant drugs in anxiety disorders: a critical review of the evidence. J Clin Psychopharmacol. 2007 Jun;27(3):263-72. doi: 10.1097/jcp.0b013e318059361a. PMID: 17502773.

Pham TL, Chrousos GP, Merkenschlager A, Petrowski K, Ullmann E. Lamotrigine Reduces Stress Symptoms of Chronic Anxiety in the Times of the Covid-19 Natural Catastrophe-A Case Report. Front Psychiatry. 2021 Jun 21;12:655079. doi: 10.3389/fpsyt.2021.655079. PMID: 34234698; PMCID: PMC8255466.

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