Lamictal (lamotrigine)
Also marketed as Lamictal XR and Lamictal ODT. An approved treatment for Focal Epilepsy.
The same compound appears under different names depending on the context. Here is how to identify Lamotrigine wherever you encounter it, plus the key facts at a glance.
- Generic name
- Lamotrigine
- Brand names
- Lamictal, Lamictal XR, Lamictal ODT
- Drug class
- Sodium channel blocker (antiseizure medication)
- Manufacturer
- GlaxoSmithKline
- How it's taken
- Taken by mouth once or twice daily (an extended-release form is once daily, and a dissolvable tablet is available).
A long-established seizure medication valued for being easy on thinking and mood, which makes it a common first-line and add-on choice. In the US, Lamictal is approved as an add-on for focal seizures from age 2 and for switching to lamotrigine alone from certain other seizure medicines from age 16, and Lamictal XR is approved for both from age 13. Starting it as a person's first and only seizure medicine is done in practice but is outside the US label. Its main catch is that it must be started slowly over several weeks to avoid a serious skin rash.
Where Lamotrigine fits
A widely used first-line and adjunctive option prized for its favorable cognitive and mood profile, but it must be titrated up slowly over weeks to reduce the risk of a serious rash.
How Lamotrigine works
Nerve cells fire by letting sodium rush in through tiny gates called sodium channels. In a seizure, this firing runs out of control. Lamotrigine binds to those sodium channels when they are overactive and slows them down, which quiets the runaway electrical activity and also reduces the release of glutamate, an excitatory brain chemical.
Because it calms overexcited cells without heavily sedating the brain, lamotrigine tends to cause less drowsiness and cognitive fog than many other seizure drugs, and it can even lift mood, which is why it is also used in bipolar disorder[1].
Mechanism: Blocks voltage-gated sodium channels to stabilize overactive neuronal membranes and reduce glutamate release
Side effects and safety
The most important risk is a skin rash, and the label carries a boxed warning, the FDA's strongest, about it. Most rashes are mild, but rarely lamotrigine can trigger a life-threatening reaction (Stevens-Johnson syndrome or toxic epidermal necrolysis). Serious rash is more common in children than in adults, and the risk is also higher when lamotrigine is taken with valproate, when the starting dose or dose increases are faster than recommended, and in people who carry a gene variant called HLA-B*1502. The risk is much lower when the dose is increased slowly, which is why the starting schedule is so gradual. Any new rash should be reported to a doctor right away.
Other common side effects include dizziness, headache, double vision, and unsteadiness, usually when the dose is raised too quickly or combined with valproate. Like all seizure medicines, it carries a class warning about a small increase in suicidal thoughts. The label also warns about a rare, life-threatening immune reaction called HLH (fever, rash, swollen glands) and about possible serious heart rhythm problems in people with certain heart conditions. It also warns about a body-wide allergic reaction (sometimes called DRESS) that can damage the liver and other organs and can be fatal, and about drops in blood cell counts, so report fever, swollen glands, unusual bruising or bleeding, or repeated infections right away. Other label warnings cover aseptic meningitis (fever, headache and stiff neck), mix-ups with drugs that have similar names, estrogen birth control lowering lamotrigine levels, and seizures if the drug is stopped suddenly[1].
This is not a complete list of side effects. Talk to your doctor or pharmacist about what to expect and when to seek medical attention.
Taking Lamotrigine
Taken by mouth once or twice daily (an extended-release form is once daily, and a dissolvable tablet is available). The defining feature is the slow start: doses begin very low and step up over roughly 5 to 6 weeks. The schedule changes depending on whether a patient is also taking valproate (which raises lamotrigine levels) or enzyme-inducing drugs (which lower them)[1].
Availability and cost
Generic versions may be available at a lower cost. Ask your pharmacist.
Help paying for Lamictal
Pick your insurance to see which help fits. Drugmaker copay cards can't be used with Medicare, Medicaid or TRICARE; charity funds are the usual route there.
- Free medicine program
Free LAMICTAL, LAMICTAL XR and LAMICTAL ODT for uninsured US or Puerto Rico residents with no prescription coverage who meet household income limits.
For: no insurance · source - Free medicine program
Free LAMICTAL, LAMICTAL XR and LAMICTAL ODT for Medicare Part D patients who meet income limits and have spent $600 on prescriptions this calendar year.
For: Medicare · source
Good to know: Run by the GSK Patient Access Programs Foundation, a separate nonprofit. Covers the GSK brand (LAMICTAL, LAMICTAL XR and LAMICTAL ODT) only, not generic versions. Income limits apply (48 states/DC: $47,880 for 1 person, $99,000 for 4). GSK's copay and coupon program lists do not include LAMICTAL, LAMICTAL XR and LAMICTAL ODT. Generic lamotrigine is widely available.
- From a charity · The Assistance FundEpilepsy fundWaitlist
Pays for: Copays, coinsurance, deductibles and other health-related expenses.
The foundation says: “WAITLIST — Accepting Waitlist Patients. TAF is currently accepting requests to join the enrollment waitlist for this program. Waitlists a…”
Clinical trial results
The FDA approved lamotrigine in December 1994 for focal (partial-onset) seizures, based on placebo-controlled add-on trials showing meaningful reductions in seizure frequency. Over the following decades it earned approvals for additional seizure types, for children, and for maintenance treatment of bipolar disorder, and it is now a heavily used generic worldwide[1].
Development history
Lamotrigine was developed by the company that became GlaxoSmithKline and reached the U.S. market in 1994 as Lamictal. It was one of the first of the modern 'second-generation' seizure drugs designed for better tolerability than older agents like phenytoin and carbamazepine. Its dual usefulness in epilepsy and mood stabilization has kept it in wide use long after generic versions arrived[1].
Explore Focal Epilepsy trials
Other Focal Epilepsy treatments
Common questions about Lamotrigine
▸What is Lamotrigine (Lamictal)?
A long-established seizure medication valued for being easy on thinking and mood, which makes it a common first-line and add-on choice. In the US, Lamictal is approved as an add-on for focal seizures from age 2 and for switching to lamotrigine alone from certain other seizure medicines from age 16, and Lamictal XR is approved for both from age 13. Starting it as a person's first and only seizure medicine is done in practice but is outside the US label. Its main catch is that it must be started slowly over several weeks to avoid a serious skin rash.
▸How does Lamotrigine work?
Nerve cells fire by letting sodium rush in through tiny gates called sodium channels. In a seizure, this firing runs out of control. Lamotrigine binds to those sodium channels when they are overactive and slows them down, which quiets the runaway electrical activity and also reduces the release of glutamate, an excitatory brain chemical.
Because it calms overexcited cells without heavily sedating the brain, lamotrigine tends to cause less drowsiness and cognitive fog than many other seizure drugs, and it can even lift mood, which is why it is also used in bipolar disorder[1].
▸What are the side effects of Lamotrigine?
The most important risk is a skin rash, and the label carries a boxed warning, the FDA's strongest, about it. Most rashes are mild, but rarely lamotrigine can trigger a life-threatening reaction (Stevens-Johnson syndrome or toxic epidermal necrolysis). Serious rash is more common in children than in adults, and the risk is also higher when lamotrigine is taken with valproate, when the starting dose or dose increases are faster than recommended, and in people who carry a gene variant called HLA-B*1502. The risk is much lower when the dose is increased slowly, which is why the starting schedule is so gradual. Any new rash should be reported to a doctor right away.
Other common side effects include dizziness, headache, double vision, and unsteadiness, usually when the dose is raised too quickly or combined with valproate. Like all seizure medicines, it carries a class warning about a small increase in suicidal thoughts. The label also warns about a rare, life-threatening immune reaction called HLH (fever, rash, swollen glands) and about possible serious heart rhythm problems in people with certain heart conditions. It also warns about a body-wide allergic reaction (sometimes called DRESS) that can damage the liver and other organs and can be fatal, and about drops in blood cell counts, so report fever, swollen glands, unusual bruising or bleeding, or repeated infections right away. Other label warnings cover aseptic meningitis (fever, headache and stiff neck), mix-ups with drugs that have similar names, estrogen birth control lowering lamotrigine levels, and seizures if the drug is stopped suddenly[1].
▸How is Lamotrigine taken?
Taken by mouth once or twice daily (an extended-release form is once daily, and a dissolvable tablet is available). The defining feature is the slow start: doses begin very low and step up over roughly 5 to 6 weeks. The schedule changes depending on whether a patient is also taking valproate (which raises lamotrigine levels) or enzyme-inducing drugs (which lower them)[1].
▸Is Lamotrigine FDA approved?
Yes, Lamotrigine (Lamictal) is FDA approved (1994) for the treatment of Focal Epilepsy.
▸What is lamotrigine (Lamictal) used for?
The FDA approved lamotrigine (Lamictal) in December 1994 for focal (partial-onset) seizures, based on placebo-controlled add-on trials showing meaningful reductions in seizure frequency. In the US, Lamictal is approved as an add-on for focal seizures from age 2 and for switching to lamotrigine alone from certain other seizure medicines from age 16, and Lamictal XR is approved for both from age 13. It later earned approvals for additional seizure types and for maintenance treatment of bipolar disorder, and it is now a heavily used generic worldwide. [1]
▸What are the side effects of lamotrigine?
The most important risk of lamotrigine is a skin rash, and the label carries a boxed warning, the FDA's strongest, because rarely it can trigger a life-threatening reaction (Stevens-Johnson syndrome or toxic epidermal necrolysis). Serious rash is more common in children, when lamotrigine is taken with valproate, when the dose is raised faster than recommended, and in people who carry the HLA-B*1502 gene variant, so any new rash should be reported to a doctor right away. Other common side effects include dizziness, headache, double vision and unsteadiness. The label also warns about a small increase in suicidal thoughts, the rare immune reactions HLH and DRESS, drops in blood cell counts, serious heart rhythm problems in people with certain heart conditions, aseptic meningitis, and seizures if the drug is stopped suddenly. [1]
▸How is lamotrigine taken?
Lamotrigine is taken by mouth once or twice daily; an extended-release form (Lamictal XR) is once daily, and a dissolvable tablet (Lamictal ODT) is available. Its defining feature is a slow start: doses begin very low and step up over roughly 5 to 6 weeks to reduce the risk of serious rash. The schedule changes depending on whether a patient is also taking valproate, which raises lamotrigine levels, or enzyme-inducing drugs, which lower them. [1]
▸How does lamotrigine work?
Lamotrigine binds to sodium channels on nerve cells when they are overactive and slows them down, which quiets the runaway electrical activity of a seizure and also reduces the release of glutamate, an excitatory brain chemical. Because it calms overexcited cells without heavily sedating the brain, lamotrigine tends to cause less drowsiness and cognitive fog than many other seizure drugs. It can even lift mood, which is why it is also used in bipolar disorder. [1]
Sources and references
Every factual claim on this page is drawn from the public sources listed below. Click any reference to open the original document.
- U.S. Food and Drug Administration (Drugs@FDA). LAMICTAL (lamotrigine) tablets, Prescribing Information (Initial U.S. Approval: 1994). https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/020241s068s069,020764s061s062,022251s032s033lbl.pdf