Treating Mental Health Issues With Lamotrigine (Lamictal)
If you’ve been prescribed Lamotrigine, you might wonder why it’s a good fit and what you should be aware of.
Lamotrigine (or Lamictal, as it’s often called), is an epilepsy medication that is also prescribed to treat bipolar disorder.¹ Lamotrigine works by helping to calm overactive electrical signals in the brain. It affects how certain nerve cells communicate, especially those that release glutamate – a chemical linked to mood and energy levels.²
By slowing certain brain activity, Lamotrigine makes mood shifts less reactive. It doesn’t sedate or numb emotions. But over time, many people say their mood feels more even. The sharp drops don’t hit as hard, and the swings aren’t quite as disruptive. Lamotrigine is the only mood stabilizer that reduces mood swings by lifting depression instead of suppressing mania.³
If you’ve got questions you want answered about Lamictal, this guide walks through:
- What Lamictal is prescribed for
- How long it takes for Lamictal to start working
- Signs that Lamictal is working
- Lamictal side effects to be aware of
- Expected doses of Lamictal
- How to stop taking Lamictal safely
- Where to get Lamictal and mental health assistance
What Is Lamictal Used For?
Lamictal is used in both neurology and psychiatry. It helps calm certain electrical signals in the brain. That’s useful in epilepsy, and also in bipolar disorder – though for different reasons.
Lamictal for Bipolar Depression
While some doctors prescribe Lamictal for Bipolar Depression, it’s important to note that this medication doesn’t treat mania. It’s also not fast-acting. What it does is help reduce the risk of depressive episodes over time. That’s where it’s most effective. People who lean more toward long depressive periods may be prescribed Lamictal to help keep those lows from happening as often – or from lasting as long.
Lamictal for Epilepsy
In epilepsy, Lamictal works by lowering the chance of sudden bursts of electrical activity that can lead to seizures. Some people take it alone. Others take it with different medications, depending on the kind of seizures they have. It tends to be well tolerated and is often chosen because it doesn’t cause as much sedation as some older options.
How Long Does Lamictal Take to Work?
If you’re wondering how long does Lamictal take to work, it’s best to note that it’s not a quick fix. Lamictal takes time to build up in the body. The dose has to be increased slowly, which is part of the reason it doesn’t work right away. For most people, it’s a few weeks before any changes start to show. It may take longer – sometimes six weeks or more – to notice the full effect.⁴
How long it takes depends on the target dose, how gradually it’s increased, and what symptoms it’s meant to help with. The timing isn’t the same for everyone.
Signs Lamictal Is Working
If Lamictal is being used for bipolar depression, improvement usually shows up as fewer days of feeling low or a shorter, less intense drop in mood. Things might also feel more stable. Some of the other signs Lamictal is working are that people notice they can think a little more clearly or keep up with daily routines more easily.
For epilepsy, the clearest sign is a reduction in seizure activity. That might mean fewer episodes or a change in how intense they are. The shifts tend to be slow and steady, rather than dramatic.
Lamotrigine Side Effects
Lamotrigine is usually well tolerated, especially once the dose is stable. But like any medication, it can come with side effects. Some Lamotrigine side effects show up early, especially during the dose titration phase. Others are more dose-related and may not appear until later.
Most common side effects of Lamotrigine:⁵
- Headaches
- Rash
- Nausea
- Dizziness
- Tiredness
These often pass on their own. But any sudden skin changes, mood shifts, or cognitive changes should be taken seriously.
Lamictal and Skin Rash
Having a conversation with your mental health care provider about Lamictal and skin rash would be wise as developing a rash is the biggest concern with Lamotrigine.⁶ It’s rare, but it can be serious if it spreads or becomes systemic. This is why the dose is increased slowly – a fast titration schedule raises the risk.
Most rashes are mild. Even so, any rash that appears while starting or adjusting Lamotrigine should be mentioned. If there’s peeling, blistering, or fever, treatment may need to stop right away.
Lamotrigine and Mood Swings
When prescribing the medication, your doctor may want to discuss Lamotrigine and mood swings with you. Mood swings can still happen while starting Lamictal, even though it’s prescribed to prevent them. It takes time for the medication to reach a steady effect. Some people also need other medications alongside it.
If mood symptoms get worse or shift in a way that feels unfamiliar, the treatment plan might need an adjustment. This is something providers often track closely in the early stages.
Lamictal and Weight Gain
Lamictal and weight gain aren’t a common concern as it’s not usually associated with pronounced weight gain. Most people don’t report major changes. If weight does change, it’s often minor and not always directly caused by the medication.⁷
Still, if someone notices a steady increase or decrease, it’s worth bringing up. Sometimes it reflects other shifts—like appetite, stress, or energy.
Lamictal and Cognitive Function
Lamictal and cognitive function are often discussed prior to treatment. Thinking can feel a little off at first when treatment starts. Some people feel mentally sharper on Lamictal. Others feel slower or foggy, especially while adjusting to a new dose.⁸
If the fog doesn’t clear, or it starts to affect day-to-day tasks, it might be a sign to revisit the dose or timing. Everyone’s threshold is a little different.
Lamictal Dosage
Every patient’s Lamictal dosage chart will look a little different. Lamictal is always started at a low dose. The reason for that is simple – going too fast raises the risk of serious rash. The dose is increased slowly, over several weeks, to give the body time to adjust.
The schedule can look a little different depending on the reason for taking it, and whether it’s being used alone or with other medications. But in most cases, the titration follows a basic step-up plan that can look something like this:⁹
- Week 1 and 2: 50 mg once a day
- Week 3 and 4: 50 mg twice a day
- Week 5: 100 mg once a day
- Week 6: 150 mg twice a day
- Maintenance: 100 mg twice daily
Some people stay at 100 mg. Others go up to 200 mg or higher, depending on what symptoms they’re treating. The exact schedule can change based on how well the medication is tolerated, or whether other medications like valproate are in the mix.
Once a person reaches their target dose, the medication is usually taken once or twice a day, depending on how it’s absorbed and how steady the effects feel. If side effects show up during the titration process, the dose may be held longer or increased more slowly.
There’s no one-size-fits-all plan, but the slow start is consistent. It’s the safest way to bring Lamictal into a treatment plan.
Stopping Lamictal Safely
Lamictal shouldn’t be stopped all at once. If the dose comes down too fast, symptoms can come back or new ones can show up. Even if someone’s had side effects, stopping Lamictal safely requires lowering the dose gradually.¹⁰
How slowly tapering off Lamictal happens depends on how long the medication’s been taken and what it was being used for. Sometimes it’s a matter of weeks. Other times it takes longer.
If Lamictal was prescribed to treat seizures, stopping it too quickly can increase the chance of a breakthrough seizure, even if things have been stable for a while.
Lamictal Withdrawal Symptoms
Not everyone has Lamictal withdrawal symptoms, but they can happen, especially when the medication is stopped too fast. Common symptoms include:
- Irritability
- Restlessness
- Sleep disruption
- Headaches
- Mood shifts that feel more intense or come on quickly
There’s also a chance that the original symptoms (like depression or seizures) can come back. Slowing the taper helps reduce that risk and gives the brain time to adjust.
Lamictal vs Lithium
Both Lamictal and lithium are used in bipolar treatment, but they serve different roles. The choice between them often depends on what symptoms are showing up most.
Lamictal, or Lamotrigine, helps prevent depressive episodes. It’s not used for mania, and it doesn’t act quickly. This medication works best over time – quietly building stability for people who tend to fall into long, low moods.
Lithium is more of a full-spectrum stabilizer. It treats both mania and depression and has been used for decades. Doctors often turn to it when someone is cycling between extremes or needs something that can act during an acute episode. It also has protective effects, especially when it comes to reducing suicidal thoughts.
Monitoring looks different too. Lamictal doesn’t usually require blood work, but the dose has to go up slowly. Lithium needs regular lab checks to make sure blood levels stay safe, and to keep an eye on kidney and thyroid function.
When comparing Lamictal vs Lithium, keep in mind that everyone is different. Some people respond better to one than the other. It depends on history, symptom patterns, and how the body handles each medication over time.
Reach Out to Mission Connection
Have questions about Lamictal? Or unsure what the next step should be? That’s what we’re here for.
You might be starting treatment. Or thinking about it. Maybe you’ve been on it a while and something’s not sitting right. Whatever stage you’re in, you can give us a call. Someone from the team will walk through it with you.
We’re here when you’re ready – contact us today by phone or get started here.
References
- Bechtel, N. T., Fariba, K. A., & Saadabadi, A. (2025). Lamotrigine. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470442/
- Costa, B., & Vale, N. (2023). Understanding lamotrigine’s role in the CNS and possible future evolution. International Journal of Molecular Sciences, 24(7), 6050. https://pmc.ncbi.nlm.nih.gov/articles/PMC10093959/
- McQuillan, S. (2016, January 24). Uses of Lamictal (lamotrigine) as a mood stabilizer. HealthCentral. https://www.healthcentral.com/condition/bipolar-disorder/lamictal
- Chris, A., & Newsome, K. (2021, August 3). Four myths about lamotrigine. Psychiatric Times. https://www.psychiatrictimes.com/view/four-myths-lamotrigine
- Faught, E., Matsuo, F. U., Schachter, S., Messenheimer, J., & Womble, G. P. (2004). Long-term tolerability of lamotrigine: Data from a 6-year continuation study. Epilepsy & Behavior, 5(1), 31–36. https://www.sciencedirect.com/science/article/abs/pii/S1525505003003007
- Wang, X.-Q., Xiong, J., Xu, W.-H., Yu, S.-Y., Huang, X.-S., Zhang, J.-T., Tian, C.-L., Huang, D.-H., Jia, W.-Q., & Lang, S.-Y. (2015). Risk of a lamotrigine-related skin rash: Current meta-analysis and postmarketing cohort analysis. Seizure, 25, 52–61. https://pubmed.ncbi.nlm.nih.gov/25645637/
- Sachs, G., Bowden, C., Calabrese, J. R., Ketter, T., Thompson, T., White, R., & Bentley, B. (2006). Effects of lamotrigine and lithium on body weight during maintenance treatment of bipolar I disorder. Bipolar Disorders, 8(2), 175–181. https://pubmed.ncbi.nlm.nih.gov/16542188/
- Aldenkamp, A. P., & Baker, G. (2001). A systematic review of the effects of lamotrigine on cognitive function and quality of life. Epilepsy & Behavior, 2(2), 85–91. https://pubmed.ncbi.nlm.nih.gov/12609190/
- British National Formulary. (n.d.). Lamotrigine. Retrieved May 20, 2025, from https://bnf.nice.org.uk/drugs/lamotrigine/
- MedlinePlus. (n.d.-b). Lamotrigine. Retrieved May 20, 2025, from https://medlineplus.gov/druginfo/meds/a695007.html
