Lamotrigine

Summary

Lamotrigine is a drug that works by blocking sodium channels.

Clinically, it is used as a broad spectrum antiepileptic drug, meaning it can treat both generalized and focal seizures. In addition to seizures, lamotrigine is also used as a mood stabilizer to treat bipolar disorder.

Lamotrigine can cause several side effects, including sedation, headache, dizziness, and diplopia. Skin-related reactions, such as rash, Stevens-Johnson Syndrome, and DRESS syndrome, are also possible. Many patients may also experience nausea and vomiting. Lastly, lamotrigine may cause an increased risk of suicidal thoughts and behaviors.

Key Points

• Lamotrigine
  • Mechanism
    • Blocks Na+ channels
      • Because Na+ channels are used for most neural action potentials, this can suppress neuronal activations, leading to broad-spectrum antiepileptic effects
  • Clinical Use
    • Treats seizures (antiepileptic)
      • Broad-spectrum
        • Treats partial (focal) seizures
        • Treats generalized (tonic-clonic) seizures
    • Treats bipolar disorder
      • Mood stabilizer
      • Particularly useful for treating depressed phase
  • Side Effects
    • Sedation
    • Dizziness
    • Rash
    • Headache
    • Nausea/vomiting
    • Diplopia
    • DRESS
    • Steven Johnson Syndrome (SJS)
      • Drug-induced skin and mucosal reaction that may lead to necrosis and peeling
      • Dose-limiting and relatively common; dose must be titrated slowly
    • May increase suicide risk