I was scheduled an appt. with a psychiatrist sometime back. Upon my first visit, and as it progressed, I was already beginning to see where we were going. Bi-Polar Disorder II. I mean, everyone is Bi-Polar. As such, I was scheduled another appt. which kept taking us back around to the BPD topic. This quickly led to medications, Lithium was discussed, then Depakote. He was hesitant on Depakote due to my past affinity for whiskey (WAY BACK) and the toll it takes on one's liver. Lithium was on deck. But his concern was the narrow line of efficacy. I had mentioned to him, due to a friend telling me about Lamotrigine, that as a possibility. Well lucky me, he became pretty excited, and relieved all at the same time. Lamotrigine it was... That was over a year ago, and while I received the many bottles of it, starter 25mg, then 50mg, then 100mg final target dosage, I have not taken ONE pill. Im sorry, when I read the potential DEATH RASH side of it, I was out. No thanks! I'd rather be stark raving mad and be alive, than to die of some creeping death rash. How likely in all honesty are those occurrences? has anyone taking it experienced a rash at all? I mean, I am not even sure I have BPDII in the first place, and I already take Gabapentin which was an anti-convulsant in the beginning, turned nerve pain drug. Thank you!
Bipolar disorder - lamotrigine and certain death?
Question posted by shokaree on 14 June 2024
Last updated on 22 June 2024
3 Answers
Hi, shokaree!
My personal experience with lamotrigine over the past 10 years has been great and no short- or long-term side effects. Also, it’s been extremely effective.
The rash you’re referring to may be Steven-Johnson syndrome which is very rare affecting about 0.04% of users. Any sign of a rash in the first 5 days to 8 weeks after starting the medication should be reported to your doctor but most lamotrigine rashes can be treated by simply stopping the medication.
In my case the benefit certainly outweighed the slight risk.
Regards, WildCat
PS, I’m Bipolar l and I take 300mg/day.
That is the best news I have heard today. In all honesty, I don't know. While it is true that I have been on anti-depressants since the Triclyc variety that took 6 months to see any effects, I have struggled at times. Never way high, never a deep dive low, but I have experienced events such as, I am in a perfectly good mood no real worries, and in fact have been in a exceptionally good mood. Then, I will be sitting at my desk and I will feel it coming... A low front, that gets heavier, and lower as it moves in. Somewhere always before it full cuts loose with rain, and wind, I feel the crushing weight of it. My head is now down on my desk and it is the deepest, sorrow and just a dak stormy feeling in my head. After some time passes, it varies, it will slowly begin to lift and I am back to feeling somewhat normal, although that experience is by no means normal.
The highs tend to not be much other than what feels like an incredibly good day! I am more outgoing, a trip to my frequented convenience store has me feeling especially, good and cocky as I enter, raise my arms up and apart, and say loudly "MY CHILDREN!" speaking to the clerks whom I know due to my frequent visitation. I apologize as this went off topic, thank you. Hearing someone real say that helps much!
I have severe anxiety and depression. I was told I’m treatment resistant but the NP I see keeps trying. The latest is 100mg lamotrigine along with 45mg mirtizapine and 1.5 mpg Klonopin, which I’ve been on forever. I wonder as my NP titrates the Lamotrigine up, if anyone has had experience they would share on this? I’m really struggling. Thank you.
I’ve been taking Lamotrigine for over twenty years with no problems. Currently on 400mg/day. I think the rash issue is very rare, but understand your concern.
Perhaps it is rarer than I listened long enough to grasp. I saw pictures of someone that had it, Thanks Internet! and man, it was horrible looking. I also consider, its 25mg to start with, I mean come on, that is a pretty low dose... I really appreciate the feedback. When others can't seem to live with you, it is one thing, when you can hardly live with yourself? thats a problem!
Hello,
I am bpd1 and I was on thre Lamictal name brand for lamotrigine for a couple of years.
I really didn't feel it helped with stabilizing my mood and didn't experience the potential "rash" or other possible side effects, as you are aware everyone reacts differently to everything in life, meds included obviously, stopped taking it a while ago.
From Drugs.com
In adult patients (n=3348), serious rash associated with hospitalization and discontinuation was reported in 0.3% of patients in premarketing epilepsy trials. In bipolar trials, serious rash occurred in 0.08% of patients receiving this drug as initial monotherapy and 0.13% of patients receiving this drug as adjunctive therapy. In worldwide postmarketing experience, rash-related death has been reported, but the numbers are too few to permit a precise estimate of rate.
In a prospectively followed cohort of pediatric patients 2 to 17 years old, the incidence of serious rash was approximately 0.3% to 0.8%. In a prospectively followed cohort of patients 2 to 16 years old (n=1983), 1 rash-related death occurred in a patient with epilepsy taking this drug as adjunctive therapy.
Evidence has show the inclusion of valproate in a multidrug regimen increases the risk of serious, potentially life-threatening rash in both adult and pediatric patients. In pediatric patients who used valproate concomitantly for epilepsy, 1.2% (6 of 482) experienced a serious rash (placebo=0.6%). In adults, 1% of patients of patients receiving this drug in combination with valproate (n=584) experienced a rash (placebo=0.16%).
References relevant to chosen section (Show all references)
2. (2001) "Product Information. Lamictal (lamotrigine)." Glaxo Wellcome
3. Cerner Multum, Inc. "UK Summary of Product Characteristics."
4. Pharmaceutical Society of Australia (2006) APPGuide online. Australian prescription products guide online. http://www.appco.com.au/appguide/default.asp
18. Hillemacher T, Bleich S, Kornhuber J, Frieling H (2006) "Hair loss as a side effect of lamotrigine treatment." Am J Psychiatry, 163, p. 1451
19. Schwartz R, Avello E, Palisson F (2008) "Lamotrigine-induced toxic epidermal necrolysis treated with intravenous immunoglobulin and amniotic membranes." Arch Dermatol, 144, p. 724-6
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Further information
- Lamotrigine uses and safety info
- Lamotrigine prescribing info & package insert (for Health Professionals)
- Side effects of Lamotrigine (detailed)
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