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Lamotrigine Brand names :: Lamictal     Lamotrigine, is a medicine used to treat epilepsy. Lamotrigine prevents epileptic fits by preventing excessive electrical activity in the brain. It does this by preventing sodium from entering nerve cells when they begin to fire rapid and repetitive electrical signals. A build up of sodium in the nerve cells is necessary for the electrical signal to build up and be passed on to other nerve cells. As lamotrigine prevents this, it helps stabilise the electrical activity in the brain.     Preventing the build-up of the electrical signal also prevents the release of a neurotransmitter called glutamate from the nerve cells in the brain. Neurotransmitters are chemicals that are stored in nerve cells and are involved in transmitting messages between the nerve cells. Glutamate is a neurotransmitter that acts as a natural 'nerve-exciting' agent. It is released when electrical signals build up in nerve cells and subsequently excites more nerve cells. It is thought to play a key role in causing epileptic seizures. Reducing the release of glutamate from the nerve cells in the brain is another way in which lamotrigine helps stabilise the electrical activity in the brain and prevent epileptic fits.     In addition to its licensed use for treating epilepsy, lamotrigine is used off-licence by specialists as a mood stabiliser for treating people with the psychiatric illness, bipolar affective disorder. This use is not licensed, but the medicine has been shown to be effective in people with bipolar disorder who have not responded to the traditional mood stabilisers (lithium, carbamazepine, valproate). Lamotrigine is used for treating episodes of high or low mood and for helping to prevent episodes of ill health in these people. It is not fully understood how lamotrigine works in this illness, but is thought to be to do with the reduction of glutamate in the brain. Warning!     Adverse skin reactions have been reported with lamotrigine. These reactions are usually mild and get better on their own, but can on rare occasions be more serious and potentially life-threatening. The risk is higher in children under 12 years of age and in people who are also taking the medicine valproate. When starting treatment with lamotrigine the dose is increased gradually to minimise the risk of developing a skin rash. For this reason it is very important to follow the instructions you are given with this medicine, and not to exceed the prescribed dose. If you or your child develop a rash, fever, facial swelling or swollen glands while taking this medicine you should consult your doctor immediately. If the doctor decides the reaction is related to this medicine you will need to stop taking it.     You should not stop taking this medicine suddenly unless your doctor tells you otherwise, as this may result in your seizures returning or getting worse. If it is decided that you should stop taking this medicine, it should be withdrawn gradually, following the instructions given by your doctor. If for any reason you stop treatment for longer than five days and then restart, your doctor may want you to increase your dose gradually, as when you first started the medicine, to minimise the risk of getting a skin reaction.     This medicine may cause dizziness and double vision. As a result it could reduce your ability to drive or operate machinery safely. You should discuss this with your doctor. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.     This medicine may rarely cause a decrease in the normal amounts of blood cells in the blood. For this reason you should consult your doctor immediately if you experience any of the following symptoms: unexplained bruising or bleeding, purple spots, sore throat, mouth ulcers, high temperature (fever), feeling tired or general illness. Your doctor may want to take a blood test to check your blood cells.     The safety and efficacy of this medicine in children under two years of age has not been established by the manufacturer. Use with caution in Elderly people. Decreased liver function. Kidney failure. Parkinson's disease. History of allergic reactions or rash due to other antiepileptic medicines. Side effects Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect. Skin rashes. Headache. Drowsiness. Dizziness. Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain. Pain in the joints or back pain. Difficulty in sleeping (insomnia). Visual disturbances, such as double vision or blurred vision. Shaking, usually of the hands (tremor). Confusion. Agitation. Irritability. Aggression. Hallucinations. Disturbances in the numbers of blood cells in the blood. Shaky movements and unsteady walk (ataxia). Severe blistering skin reaction affecting the tissues of the eyes, mouth, throat and genitals (Stevens-Johnson Syndrome). Disturbances of liver function. The side effects listed above may not include all of the side effects reported by the drug's manufacturer. It is recommended that people who are taking any antiepileptic medicines should avoid taking the herbal remedy St John's wort (Hypericum perforatum). This is because St John's wort may affect the level of antiepileptic medicines in the blood and could increase the risk of seizures.