Lamictal Withdrawal: Symptoms, Timeline & Treatment
One of the most frustrating things about prescription medications is that even though they can be very effective when treating a particular disorder, they have the potential to cause serious harm if misused.
This is the case with many prescription drugs that are routinely prescribed by physicians these days, and one such drug is Lamictal, also known by its generic name lamotrigine.
In this article, we will take a closer look at this mood stabilizer, analyze the dangers of its misuse, as well as highlight possible solutions for those suffering from withdrawal symptoms.
What Is Lamictal?
Lamictal the brand name for lamotrigine, is a medication primarily used in the treatment of epilepsy patients and people with bipolar disorder. It is classified as an anticonvulsant medication or anti-seizure medication but is widely recognized for its mood-stabilizing properties. Lamictal works by decreasing abnormal electrical signals in the brain, which helps to prevent seizures and stabilize mood swings in patients with mood disorders.
Research shows that lamotrigine successfully controls primary generalized tonic-clonic seizures in over 88% of cases, making it highly effective for epilepsy patients. For individuals with epilepsy, Lamictal can be prescribed as a monotherapy or in combination with other medications to control various types of seizures, including primary generalized tonic-clonic seizures and seizures in persons with Lennox-Gastaut syndrome.
In the realm of mental health, it’s particularly effective in managing the depressive phases of bipolar disorder, rather than the manic phases, making it a unique component of bipolar treatment strategies. Clinical studies indicate that lamotrigine delays the time to intervention for depressive episodes by 323 days compared to 127 days with placebo.
The effectiveness of Lamictal in treating these conditions is linked to its ability to modulate the release of neurotransmitters in the brain. It reduces the release of excitatory neurotransmitters, which can cause erratic brain activity, and increases the levels of inhibitory neurotransmitters like GABA, which help calm the brain. Lamotrigine has a half-life of approximately 29 hours, meaning it takes about 5-7 days to clear from the system.
Doctors typically prescribe a specific dose of lamotrigine depending on the condition being treated, the age of the patient, and their overall health profile. Lamictal XR (extended-release) is also available for patients with epilepsy who require Long-term use. It’s crucial for people to adhere strictly to their prescribed dosage and to consult with their healthcare provider before making any changes to how they take their medication, as improper use can lead to serious adverse effects.
How Does Lamictal Treat Bipolar Disorder and Severe Depression?
Lamictal is particularly effective in treating the depressive episodes that are a hallmark of bipolar disorder. Unlike many other mood stabilizers that primarily target manic phases, Lamictal is used to stabilize and elevate the mood, helping to prevent the lows of depression without triggering manic episodes.
The mechanism by which Lamictal treats bipolar disorder and severe depression involves the modulation of neural processes. It is believed to stabilize neuronal membranes and regulate the release of neurotransmitters, the chemicals in the brain responsible for communication between nerve cells. By inhibiting the release of glutamate, which is an excitatory neurotransmitter associated with increased nerve activity, and enhancing the action of GABA, an inhibitory neurotransmitter that promotes calmness and relaxation, Lamictal helps to balance the mood swings and reduce the severity of depressive episodes.
This dual action not only helps to dampen the intensity of electrical impulses that might contribute to the erratic behaviors seen in bipolar disorder but also aids in alleviating the debilitating symptoms of severe depression. The precise adjustment of neurotransmitter levels allows for better control of mood swings and provides a more stable emotional landscape for patients with co-occurring mental health conditions.
Recommended Dosage for Lamictal
The recommended dose for orally administered Lamictal is 500 mg per day, taken in two doses of 250 mg of immediate-release tablets, or up to 300 mg of extended-release tablets.
However, these recommendations are only valid when taking stable-dose lamotrigine as a monotherapy, without any combination with other antipsychotic medications or alternative medication.
Taking an overdose of Lamictal can result in the development of very rapid adverse reactions. One of the most common is the sudden appearance of a severe skin rash, which is associated with the onset of Stevens-Johnson syndrome, an allergic-type reaction to some types of medication. According to the Epilepsy Foundation, serious rash occurs in about 3 in 1,000 adults and 1 in 100 children taking Lamictal.
Other dangerous side effects include epidermal necrolysis and DRESS syndrome, which represents a severe immune system reaction. The FDA has issued warnings about hemophagocytic lymphohistiocytosis (HLH), a rare but serious immune system reaction, with symptoms occurring 8-24 days after treatment initiation.
Are You Misusing Lamictal? Here Are the Signs
The effective dose is so close to the maximum allowed dosage that it is normal for people taking Lamictal to not realize that they are misusing the drug until they start to experience withdrawal symptoms.
Lamictal is a psychotherapeutic drug, which means taking it has an effect on your mood when used to treat epilepsy-related depression. This makes it very easy for someone to get hooked on the pleasurable “high” that is experienced soon after taking Lamictal. As a result, there is a constant risk that even patients with genuine mental health conditions, such as depression, will be tempted to self-medicate anytime they feel down or need to escape stress and reality, potentially leading to drug addiction.
One of the common ways in which Lamictal is misused is by chewing pills that are meant to be swallowed or, in extreme cases, injecting, smoking, or snorting the powdered tablets. This recreational drug use will send the full dosage directly into the bloodstream, even though it was meant for extended-release.
By doing this, patients will bypass the digestion stage that was supposed to occur in the gastrointestinal tract, and they will immediately experience the full strength of the mood-altering drug. While this will produce the desired effect of immediately improving the patient’s mood, it will also put them at a very high risk of a drug overdose.
Overdose of Lamictal is very serious, especially when the drug is taken with other medications, such as valproic acid, and can result in the following adverse effects:
- Loss of consciousness and sedation
- An allergic-type reaction, such as a severe skin rash
- Irregular cardiovascular and heart functions, including changes in blood pressure
- Difficulties with coordination and balance difficulties
- Severe and more frequent seizure activity
- Involuntary eye movements
- Brain Fog, memory problems, forgetfulness
- Double vision or blurred vision
- Coma
- Death
With such serious consequences of its misuse, is there a way to tell if you are in danger and need to consider stopping Lamictal medication? One way to see if you are misusing Lamictal, or any other drugs, is to watch out for the following signs:
- Using Lamictal when not suffering from the relevant mental health conditions
- Taking Lamictal in higher doses than recommended by the doctor
- Resorting to different ways to take Lamictal, such as injecting or snorting
When a patient is simply misusing medication, they are still a few steps away from full-blown drug addiction. At this point, seeking medical attention can prevent some of the more serious symptoms that will be caused by having too much Lamictal in the body.
Some of the possible lamotrigine side effects and common side effects of Lamictal misuse include:
- Double vision or blurry vision, trouble concentrating/brain fog, and dizziness
- Itchy skin, tremors, skin rash, and a stiff neck
- Stomach upset and nausea, dry mouth
- Back and joint pain, fatigue, chest pain, and breathing difficulties
- Loss of appetite, weight loss, diarrhea, and constipation
- Development of swollen lymph nodes and painful sores
- Loss of coordination and balance issues
- Insomnia and sleep disturbances, including abnormal dreams
- Drowsiness, sensitivity to light, and speech problems
- Disruption of a woman’s menstrual cycle and pain, irritation of the vagina, or swelling
When Does Misuse Become Addiction?
When a patient is simply misusing medication, they are still a few steps away from full-blown addiction.
At this point, seeking medical help can prevent some of the more serious symptoms that will be caused by having too much Lamictal in the body.
Some of the possible side effects of Lamictal misuse include:
- Double or blurred vision, trouble concentrating/brain fog, and dizziness
- Itchy skin, tremors, skin rash, and a stiff neck
- Stomach upset and nausea
- Back and joint pain, fatigue, chest pain, and breathing difficulties
- Loss of appetite, weight loss, diarrhea, and constipation
- Development of swollen lymph nodes and painful sores
- Balance and coordination issues
- Insomnia and sleep disturbances, including abnormal dreams
- Drowsiness, sensitivity to light, and speech problems
- Disruption of a woman’s menstrual cycle and pain, irritation of the vagina, or swelling
Spotting the signs of addiction is not easy, especially considering that patients will often try to hide their physical, emotional, and behavioral symptoms from those closest to them.
They will also dedicate a lot more of their time and energy to finding ways to obtain the drug.
This drug-seeking behavior is a very common sign of Lamictal addiction, along with the following signs:
- Changes in physical appearance and lack of hygiene
- Secrecy and withdrawal from family and friends
- Mood swings and suicidal thoughts
- Loss of interest in hobbies
- Trying and failing to stop taking Lamictal
- The decline in work or school performance and productivity
- Legal and financial problems caused by the need to get more Lamictal
- An increase in the body’s Lamictal tolerance, which means higher doses are needed for it to become effective
Five Ways To Treat Lamictal Withdrawal Symptoms
There are better ways to treat Lamictal withdrawal symptoms when you reach a point whereby the side effects are just too much to handle.
With the assistance of a doctor, the following are five possible ways to safely get this medication out of your system while at the same time managing the symptoms of Lamictal withdrawal:
Medical Detox
Usually, the very first thing a doctor will do is start the patient on a medical detox.
The aim behind this is to gradually manage the Lamictal withdrawal process over a few days or weeks depending on the severity of the case.
This medical detox will begin with an assessment to find out the level of addiction the patient is suffering from and assess any side effects they may be experiencing.
The assessment will be done by taking blood and urine samples, which will be used to screen for Lamictal and other drugs.
It is common for patients to feel anxious, lonely, depressed, and many other symptoms of Lamictal withdrawal during this detox process, so they will need to be monitored constantly.
In-patient Medical Supervision
In some cases, the Lamictal withdrawal will be very hard on the patient, and they will start to exhibit acute withdrawal symptoms.
When this happens, the doctor may recommend that the next stage of the Lamictal withdrawal process be done on an in-patient basis.
This will mean the patient will be closely monitored by medical personnel for 24 hours a day while they complete the detox.
At this point, it may be suggested that the patient start undergoing psychological therapy to help with the depression and mood swings.
Partial Hospitalization
If the medical detox is deemed to have been successful, the patient will no longer require 24-hour monitoring unless they continue to experience withdrawal symptoms.
At this stage, they can move on to partial hospitalization, which is a combination of outpatient and inpatient treatment.
During this time, the patient will attend an intensive, structured, and supportive treatment program for six hours a day and five days a week.
These therapy sessions will focus on discussing the effects of misusing Lamictal as a mood stabilizer, as well as how to cope when they stop taking Lamictal suddenly.
The program consists of family, group, or individual sessions depending on the psychologist’s recommendations.
Outpatient Treatment
If improvement can be seen in the treatment of Lamictal withdrawal, such as the complete disappearance of brain zaps and brain flashes after they stop taking the drug, the patient can be moved on to outpatient treatment.
This stage will give them a lot more freedom to come and go as they please, and attend therapy sessions to discuss the effects of Lamictal withdrawal and its associated medical conditions.
The patient will learn how to manage issues such as stress and cravings, which are normal during withdrawal from this kind of medication.
Treating patients on an outpatient basis is normally the last stage of the treatment and is designed to prepare them for life in the outside world.
Patients must be encouraged to seek medical help from a doctor whenever they need it because having a relapse is always a possibility.
Aftercare Programs
Even though constant medical supervision will no longer be a necessity, it is helpful for patients to interact regularly with other people who have gone through the same experience.
This is why there are aftercare programs that provide people recovering from Lamictal withdrawal with support groups that they can use whenever they need to talk.
In these support groups, former patients can share strategies for preventing relapse and help each other with stress management techniques.
While it is not mandatory to attend these sessions, there is usually a higher rate of successfully beating addiction to Lamictal among those who attend than those who choose to fight the problem on their own.
Should I Stop Taking Lamictal Suddenly?
Given the severity of Lamictal withdrawal symptoms, it is not advisable to suddenly go cold turkey when trying to stop taking the drug.
This sudden shock to the body may be potentially more dangerous than misusing Lamictal.
Seizures Could Return
In particular, one of the biggest risks of Lamictal withdrawal is the return of severe seizures, which can be much worse than they were in the beginning.
The best way to avoid suffering from the more severe Lamictal withdrawal symptoms is to seek medical assistance from a doctor who is experienced in weaning patients off this kind of medication.
Help Is There if You Need It!
If you or your loved one is struggling with Lamictal withdrawal, it is important to know that you are not alone and that there is a place where you can go for help.
Many bipolar patients who have been prescribed this drug have gone through the exact same experience.
Luckily, there is a lot of help available to those who need it. Beating these symptoms of withdrawal is not easy without the help of family and friends.
However, with the implementation of a proper detox program, help from medical professionals, and some dedication to sticking to the program it is possible to enjoy a complete life, free from dependence on addictive drugs, such as Lamictal.
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FAQs
What is Lamictal brain fog?
Lamictal brain fog refers to a cognitive side effect experienced by some individuals taking Lamictal (lamotrigine), characterized by confusion, forgetfulness, and a lack of mental clarity. This symptom can impact daily activities, making it difficult to concentrate or remember tasks. Brain fog can occur during both the use of Lamictal and during the withdrawal process as the body adjusts to the absence of the medication.
How long does it take to get Lamictal out of your system?
The time it takes for Lamictal to be eliminated from your system depends on several factors, including your metabolism, age, overall health, and how long you have been taking the medication. Lamotrigine has a half-life of about 24 to 34 hours, meaning it takes approximately 5 to 7 days to clear most of the drug from the system. However, withdrawal symptoms may last longer, and the process of weaning off the drug should be managed carefully with medical supervision to ensure safety and comfort.
Are there risks associated with Lamictal overdose?
Yes, taking an overdose of Lamictal can be extremely dangerous. Symptoms of an overdose may include loss of consciousness, severe skin rash, irregular heart and cardiovascular functions, coordination and balance difficulties, severe seizures, and in extreme cases, coma or death.
Why is it important to not abruptly stop taking Lamictal if prescribed for epilepsy or bipolar disorder?
Abruptly stopping Lamictal, especially when prescribed for conditions like epilepsy or bipolar disorder, can lead to a sudden worsening of symptoms. For epilepsy, this might mean the return of severe seizures; for bipolar disorder, it could lead to the return of severe mood swings or depressive episodes.
What support options are available after completing a Lamictal detox program?
Aftercare programs are essential for long-term recovery and typically include support groups where individuals can share experiences and coping strategies. These programs help provide a network of support to manage stress and prevent relapse.
