Lamotrigine (Lamictal)

Yes. Lamotrigine is classified as both a mood stabilizer and an anticonvulsant. As a mood stabilizer, it is primarily used for the maintenance treatment of Bipolar I Disorder, helping to reduce the frequency and severity of depressive and manic episodes. It is also used in neurology to treat various types of epilepsy.

Lamotrigine is generally well tolerated, and side effects are not very common. The most common side effects are drowsiness (somnolence), rash, and cognitive effects. The FDA’s full prescribing information for Lamictal, also reports common side effects to be dizziness, headache, double or blurred vision (diplopia), nausea, vomiting, insomnia, and tremor. Other frequently reported effects include abdominal pain, diarrhea, and dry mouth. These symptoms often appear within the first few weeks of treatment and may improve as the body adjusts.

Important safety warnings:

• Serious skin reactions: Lamotrigine carries an FDA boxed warning for life-threatening skin reactions, including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) — rare but serious and potentially fatal. If any rash develops, contact your clinician immediately.
• Aseptic meningitis: The FDA prescribing information notes that lamotrigine may cause aseptic meningitis. Symptoms include neck stiffness, headache, fever, and nausea. Seek medical attention immediately if these occur.
• Mental health changes: Lamotrigine may cause suicidal thoughts in teenagers and young adults. Contact your clinician or seek emergency care if you experience these symptoms.
• Withdrawal seizures: Do not stop lamotrigine suddenly. Abrupt discontinuation may trigger seizures in individuals being treated for epilepsy. Always follow your psychiatric provider’s directions on when to stop taking medications or change dosages.

For some individuals, side effects improve after days, weeks, or months of treatment. Contact your clinician if any side effects are severe or persistent.

A lamotrigine (Lamictal) rash is a potentially severe allergic reaction to the medication. Research found that 8.3% experienced some form of adverse skin reaction while taking lamotrigine. Most of these were benign rashes — mild, maculopapular eruptions that typically appear within the first 4–8 weeks of treatment and resolve without lasting harm. The incidence of life-threatening Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) in that same review was 0.04%.

According to published research on SJS prevention with lamotrigine, the following factors significantly increase the risk of serious skin reactions:

• Rapid dose escalation: Starting at a high dose or increasing the dose too quickly is strongly associated with SJS. This is why lamotrigine requires a slow, carefully staged titration schedule. If you are taking lamotrigine and miss more than 4 consecutive days of medication, it must be titrated slowly again.
• Combination with valproate (Depakote): Valproate inhibits the liver enzymes responsible for metabolizing lamotrigine, causing lamotrigine blood levels to rise significantly. This interaction is one of the most well-documented risk factors for SJS/TEN and is why a substantially lower lamotrigine dose and slower titration is required when both medications are prescribed together.
• Pediatric age: The FDA prescribing information notes that the rate of serious rash is higher in pediatric individuals than in adults.
• Genetic factors: Certain HLA gene variants, particularly HLA-B*15:02 (more prevalent in populations of Han Chinese and Southeast Asian ancestry), have been associated with a higher risk of SJS/TEN with lamotrigine.

Lamotrigine may cause drowsiness or fatigue in some individuals, particularly when starting treatment or increasing the dose. Others may feel more alert. If you notice persistent tiredness, speak with your clinician about the timing of your dose or alternative options. Always adjust timing or dosage only when recommended by your psychiatric clinician.

No. Lamotrigine is not a controlled substance. It is a prescription-only medication, meaning it requires a clinician’s prescription to obtain, but it is not classified as a controlled substance by the DEA.

Both Lamictal (lamotrigine) and Depakote (valproate/divalproex sodium) are used as mood stabilizers in bipolar disorder and as anticonvulsants. Lamotrigine is FDA-approved for the maintenance treatment of Bipolar I and is associated with fewer metabolic side effects such as weight gain, while Depakote is FDA-approved for acute manic and mixed episodes. Importantly, these medications interact significantly—valproate can dramatically increase lamotrigine blood levels, so lower lamotrigine doses are required when both are prescribed together. The choice between them depends on your mood, episode history, tolerability, and other clinical factors.

Both Lamictal (lamotrigine) and lithium carbonate are used as maintenance treatments for bipolar disorder. Lithium has the strongest evidence for long-term mood stabilization and is one of the few psychiatric medications consistently associated with reduced suicide risk, but requires regular blood monitoring due to a narrow therapeutic range of blood levels. Lamotrigine does not require routine blood level monitoring and may be particularly effective for the depressive phase of bipolar disorder, while lithium is generally effective for depressive and manic episodes. The choice depends on your individual history, episode type, and tolerance of side effects.

Lamictal (lamotrigine) is a mood stabilizer/anticonvulsant FDA-approved for the maintenance treatment of Bipolar I Disorder, while Latuda (lurasidone) is an atypical antipsychotic FDA-approved for bipolar depression and schizophrenia. They represent different medication classes and may be prescribed together or as alternatives depending on whether the primary concern is preventing future mood episodes or treating an active depressive episode. Your clinician will consider your clinical picture when recommending one over the other.

Lamictal (lamotrigine) is a mood stabilizer primarily used for bipolar maintenance, while Vraylar (cariprazine) is an atypical antipsychotic FDA-approved for Bipolar I Disorder (manic, mixed, and depressive episodes) and schizophrenia. Cariprazine may be prescribed for acute mood episodes, while lamotrigine is more commonly used for long-term mood stabilization, particularly for the depressive pole of bipolar disorder.

Both Lamictal (lamotrigine) and Keppra (levetiracetam) are anticonvulsants used to treat epilepsy, but they have distinct mechanisms and side effect profiles. Lamotrigine is also used as a psychiatric mood stabilizer for bipolar disorder, while Keppra does not have established mood-stabilizing properties. Keppra has been associated with behavioral and mood side effects in some individuals.

Lamotrigine is not known for being addictive when taken as prescribed by a clinician. It does not have a reputation for causing chemical dependence. However, stopping suddenly may cause discontinuation effects. Always follow your psychiatric provider’s directions on when to stop taking medications or change dosages.

Lamotrigine is FDA-approved as adjunctive therapy for epilepsy in children as young as 2 years old. For bipolar disorder, it is FDA-approved for maintenance treatment in adults (age 18 and older); use in children and adolescents for mood disorders is considered off-label. All antidepressant and mood-stabilizing medications carry an FDA warning about increases in suicidal ideation for teenagers and young adults, and should only be taken as and when prescribed by an appropriately licensed medical professional.

Lamotrigine has significant drug interactions that directly affect its blood levels and safety. Valproate (Depakote) substantially increases lamotrigine levels, raising the risk of serious rash, and requires a lower lamotrigine dose. Enzyme-inducing medications such as carbamazepine, phenytoin, and rifampin can reduce lamotrigine levels. Hormonal contraceptives may also lower lamotrigine levels, potentially reducing effectiveness. Consult your prescribing clinician before starting, stopping, or combining any medications or substances with lamotrigine.

As of publication date, the cost of lamotrigine varies depending on whether you are prescribed the brand-name Lamictal or the generic version.

Generic lamotrigine:

• 25 mg — from $15.02 for 100 tablets
• 100 mg — from $10.80 for 30 tablets
• 150 mg — from $16.52 for 60 tablets
• 200 mg — from $17.40 for 60 tablets
• Titration dose packs: from ~$502.70 (blue, 35 tablets) to ~$1,393.80 (green, 98 tablets)

Brand-name Lamictal:

• 25 mg — from $1,056.89 for 100 tablets
• 100 mg — from $1,123.78 for 100 tablets
• 150 mg — from $711.64 for 60 tablets
• 200 mg — from $747.81 for 60 tablets

If you have insurance, your out-of-pocket cost will depend on your supporting diagnosis and plan type (e.g., commercial, Medicare, Medicaid) and may include a copay or coinsurance.