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Lamictal, containing the active ingredient lamotrigine, is an antiepileptic drug prescribed for the treatment of seizures. Lamictal can be used as mono-therapy or in combination with other antiepileptic drugs. It is prescribed in the United States and most European constituencies.
Indication/Usage: Lamictal is indicated in epilepsy and related health conditions. It is prescribed for the treatment of partial seizures, grand mal epilepsy (generalized tonic-clonic seizures), Lennox-Gastaut syndrome, and absence seizures in children. Lamictal is also indicated in the treatment of bipolar disorder (manic depression). Lamictal extended release formulation is indicated only in adults and children over 13 years of age. Lamictal can also be used with close monitoring in some off label indications in specific populations such as elderly patients and those dealing with decreased liver functions, and kidney failure issues.
Dose, Administration and Dosage forms: Lamictal is manufactured in three tablet forms with varying strengths. Regular tablets are available in 25 mg, 100 mg, 150 mg, and 200 mg strengths; chewable dispersible tablets in 2 mg, 5 mg, and 25 mg strengths; and orally disintegrating tablets (ODT) in 25 mg, 50 mg, 100 mg, and 200 mg strengths. The regular and ODT tablets can be prescribed to children 2 years old and older in combination therapy.
Mechanism of action: Lamictal contains the active ingredient lamotrigine which is a potential sodium channel blocker. Lamotrigine acts on pre-synaptic voltage-dependent sodium channels and inhibits the release of aspartate and glutamate. This results in the depolarization of these channels, thus inhibiting uncontrolled repetitive firing and excessive electrical discharge in the brain. This reduced electrical discharge results in better control of partial seizures, grand mal epilepsy and other related conditions.
Side-effects and safety profile: Various serious side-effects reported in Lamictal clinical trials include major skin rashes, joint pain, impaired liver function, hallucinations, agitation, blurred vision, coordination disturbances, and shaking. There are some other non-serious side effects reported in Lamictal clinical trials which include upset stomach, nausea, vomiting, diarrhea, back pain, dizziness, insomnia, headaches, drowsiness, irritability, etc.
Any skin rashes occurring while taking Lamictal must be immediately reported to a physician, as these rashes may signal a life-threatening condition. This risk is higher in children under 12 years of age. These hypersensitive reactions are reported to be linked with hepatitis, hepatic failure, neutropenia, thrombocytopenia, pancytopenia, etc.
Lamictal should not be discontinued suddenly, as doing so may result in the return and worsening of seizures.
Lamictal may cause double vision, so patients taking Lamictal should not drive or operate heavy machinery.
During clinical trials, a small number of cases of suicidal thoughts and behaviors have been reported in patients taking Lamictal. Therefore, any mood changes should be immediately discussed with a physician.
The safety and efficacy of Lamictal in children under two years of age has not yet been proven, so children under the age of two should not take Lamictal.
Patients who have experienced an allergic reaction to Lamictal should not take this medication.
Epilepsy patients who are pregnant or may become pregnant should discuss taking Lamictal with a physician, because large doses of Lamictal may cause spina bifida in the fetus.
Nursing mothers should only take Lamictal after thoroughly discussing the risks with a physician, since Lamictal does excrete through breast milk.
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