Lamictal is the brand name for the antiepileptic medication lamotrigine, which is FDA-approved to treat epileptic seizures and stabilize moods in people diagnosed with bipolar disorder. Typically prescribed in an extended-release format for ongoing and long-term management of symptoms, Lamictal comes in tablet form: as a chewable tablet and as a tablet that dissolves in the mouth.
Lamictal has anticonvulsant properties as it is believed to slow down some of the hyperactive electrical impulses and nerve firings in the brain that can lead to seizures. It is usually taken once or twice a day to keep symptoms in check. Lamictal is generally considered to be more helpful in managing the depressive symptoms of bipolar disorder, which is a mood disorder characterized by intense and significant mood swings from extreme “highs” (manic episodes) to very low “lows” (depressive episodes), than the manic symptoms.
While Lamictal isn’t an antidepressant per se and not often considered a frontline treatment for depression, it may be useful in keeping bipolar depressive moods more stable and less extreme.
Lamotrigine is thought to work to decrease the activity of some of the brain’s excitatory neurotransmitters, or chemical messengers that induce stimulation while activating inhibitory neurotransmitters like GABA, which acts like a natural sedative and tranquilizer, slowing down nerve firings, the journal Neuropsychiatric Disease and Treatment publishes.
Lamictal is a psychotherapeutic prescription medication. As such, it does have some risks and side effects associated with its use. Prescription drug abuse is a major public health concern in the United States, as the National Institute on Drug Abuse (NIDA) publishes that around 52 million Americans, which makes up about 20 percent of the population aged 12 and older in the US, have taken a prescription medication for purposes other than necessary medical reasons at least once in their lifetimes. Using a prescription medication without a needed and legitimate medical reason is considered drug abuse.
Lamictal may be abused in an attempt to self-medicate emotional symptoms, as a method of escaping reality or coping with stress, or to produce a pleasurable “high.” The abuse potential of Lamictal is likely not as great as that of other prescription medications, but it may still be abused, which can be dangerous and risky.
NIDA warns that about 14 percent of people who misused a prescription drug in the past year suffer from abuse of and dependence on the substance.
Lamictal may be abused by chewing the non-chewable versions of the tablet or by crushing them and then snorting, smoking, or injecting the resulting powder. This will send the entire dosage into the bloodstream all at once instead of the medication being digested and broken down in the stomach and by the gastrointestinal system.
Lamictal is often formatted in an extended-release formulation, which is designed to be time-released in the body over a set amount of time. Crushing it can bypass this controlled-release function and cause the whole dose to take effect at once. This can be highly dangerous and increases the risk for a fatal overdose.
The FDA prescription label for Lamictal warns that an overdose on the drug can cause more seizures, sedation and a possible loss of consciousness, difficulties with coordination and balance, involuntary eye movements, irregular heart and cardiovascular functions, coma, or even death. If Lamictal is taken with other drugs or alcohol, the risks and complications are even greater. There is no specific antidote to reverse a Lamictal overdose; it should be considered a medical emergency requiring immediate professional help.
Possible Side Effects of Lamictal Use and Abuse
Typically, if used under direct medical supervision for necessary medicinal purposes, Lamictal can be taken responsibly and safely. There are some side effects that can occur even when taking it as directed, however.
Pharmacy Times explains that Lamictal has a “black-box” warning to let people know that it may cause serious and even life-threatening skin rashes in some cases. Children, or people who are also taking valproate or valproic acid with Lamictal, may be at an increased risk for developing Stevens-Johnson syndrome, or toxic epidermal necrosis, which is a rare and potentially fatal skin reaction and disorder of the skin and mucous membranes.
Lamictal may also interfere with emotional regulation and can increase potential suicidal ideations and actions. The National Alliance on Mental Illness(NAMI) reports that antiepileptic drugs like lamotrigine may double the number of suicidal thoughts or behaviors in a person. More mood disturbances, such as increased anxiety, aggression, hostility, irritability, agitation, impulsivity, mania, and restlessness, may be possible side effects of Lamictal.
Further potential side effects of Lamictal, as published by the US National Library of Medicine (NLM), can include:
- Double or blurred vision
- Stomach upset and nausea
- Loss of appetite and weight loss
- Insomnia and sleep disturbances, including abnormal dreams
- Trouble concentrating
- Balance and coordination issues
- Back and joint pain
- Itchy skin
- Speech problems
- Disruption of a woman’s menstrual cycle and pain, swelling, or irritation of the vagina
- Chest pain
- Sensitivity to light
- Breathing difficulties
- Stiff neck
Abusing Lamictal increases all of the potential side effects. Recreational use of the drug can also make a person more likely to do things they wouldn’t normally do, as it can interfere with normal and rational thought processes and decision-making abilities. Vulnerability to injury, accidents, and consequences of unsafe sexual encounters increase with Lamictal abuse. Long-term side effects of Lamictal abuse can include an increased incidence of drug dependence and likelihood for addiction.
Abusing Lamictal increases all of the potential side effects.
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Spotting Lamictal Addiction
Addiction is a brain disease. In addition to physical ramifications on a person’s body and health, it also brings emotional, social, and behavioral costs. Someone struggling with addiction is more likely to take bigger risks while under the influence of Lamictal and may not be able to think through or care about potential consequences of their actions. They may spend most of their time trying to figure out how to get more of the drug, taking it, and then recovering from the crash that often follows a drug high. Individuals may seek out additional prescriptions of Lamictal even if they don’t have legitimate medicinal reasons, potentially “doctor shopping,” or going to more than one doctor to try and get it. They may take more Lamictal at a time than they are prescribed, take it more often than they are supposed to, or keep taking it after there is no longer a medical reason to do so.
Drug-seeking behaviors are common signs of addiction, and individuals may steal, buy, borrow, or ask for these medications from friends or loved ones. Any nonmedical use of Lamictal is abuse and cause for concern.
Signs of addiction can include:
- Secrecy and withdrawal from friends and family
- Loss of interest in hobbies, things, or activities that were previous priorities
- Possible change in physical appearance and lack of attention to personal hygiene
- Mood swings and a potential shift in personality, acting in ways that are out of character
- Inability to control how often and how much of the drug is taken at a time
- Wanting to stop taking the drug and trying more than once to do so, but not being able to
- A decline in grades at school or a drop in production at work
- Continued use of the drug despite knowing it will be harmful
- Use of the drug in situations that may be dangerous or risky
- Possible financial and/or legal issues related to drug use
- Lack of ability to consistently keep up with daily chores and obligations
- Drug tolerance (needing to take more of it to feel its effects), dependence (when the brain relies on its interaction), and withdrawal symptoms (physical and emotional symptoms that occur when the drug wears off)
Almost 7.5 million American adults struggled with addiction involving an illicit drug in 2016, the National Survey on Drug Use and Health (NSDUH) publishes. The good news is that drug abuse and addiction are manageable with comprehensive and professional treatment.
Getting Help for Misuse of Lamictal
Treatment options for Lamictal abuse and addiction are varied and should be catered to the specific individual. Someone who hasn’t been struggling with abuse of the drug for very long and who does not suffer from significant Lamictal dependence may do great in an outpatient treatment program. A step up from outpatient services are intensive outpatient programs (IOPs), which are helpful for people who need the structure and methods of an inpatient program but who may also have work, school, or family obligations that require them to be home in the evenings. Residential or inpatient addiction treatment programs provide the highest level and standard of care, with supervision, structure, and stability around the clock 24 hours a day, seven days a week.
All addiction treatment programs will generally include a combination of therapeutic, pharmaceutical, and supportive methods. Counseling, behavioral therapy, medication management, treatment for co-occurring disorders, support groups, relapse prevention tools, educational programs, and more may be included in a complete addiction treatment program. Holistic measures, such as massage therapy, yoga, chiropractic care, art therapy, mindfulness meditation, nutrition planning, and fitness programs, may also be included.
Lamictal can cause a person to suffer from withdrawal symptoms that may become significant if the medication is stopped suddenly, or “cold turkey.” If a person has been taking or abusing the drug for any length of time then medical detox may be the first stage of a treatment program. A medical detox program will slowly lower the dosage of Lamictal safely over a scheduled amount of time to minimize the potential for seizures, sleep disturbances, physical discomfort, and significant mood swings that can accompany the drug’s withdrawal. Withdrawal symptoms generally begin within the first 12-24 hours of stopping Lamictal and can last several days to weeks. Tapering, or slowly weaning off Lamictal, can help to minimize these potential withdrawal symptoms.
Other medications, such as antidepressants, may be helpful during withdrawal and medical detox. A medical detox program usually only lasts a few days until a person is physically stable and can enter into a drug addiction treatment program.
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