MARK ZAUSS - THERAPY
  • Home
  • Credentials
    • Published Articles
  • ADHD
    • Adult ADHD Self-Report Scale
    • ADHD Comprehensive Assessment
    • ADHD Management
    • ADHD Atypical Symptoms
    • ADHD Medications >
      • Adderall
      • Vyvanse
      • Methylphenidate
      • Concerta
      • Focalin (dexmethylphenidate)
      • Guanfacine (Intuniv)
      • Atomoxetine (Strattera)
      • Clonidine (Kapvay)
      • Onyda XR
      • Wellbutrin
      • Qelbree
      • Azstarys
      • Xelstrym
    • ADHD Medication for Anxiety >
      • Sertraline
      • Wellbutrin
      • Escitalopram (Lexapro)
      • Duloxetine (Cymbalta)
      • Venlafaxine (Effexor)
      • Buspirone (Buspar)
      • Fluoxetine (Prozac)
      • Paroxetine (Paxil)
      • Propranolol (Inderal)
      • Accutane - Adverse effects
    • Pomodoro Technique
    • ADHD Neurochemical
    • ADHD Worksheets
  • Anxiety
    • Insomnia
    • Sertraline
    • Buspirone (Buspar)
    • Fluoxetine (Prozac)
    • Effexor
    • Paroxetine (Paxil)
    • Escitalopram (Lexapro)
  • AUD
    • AUD Medications >
      • Naltrexone
      • Acamprosate
      • Disulfiram (Antabuse)
      • Topamax
      • Gabapentin
    • What to expect
    • Nutrition
    • Resources
    • Overcoming Shame
    • Health and Alcohol
    • AUD Videos
  • Bipolar
    • Bipolar Disorder Treament
    • Bipolar Disorder Worksheets
    • Bipolar Disorder Medications >
      • Abilify
      • Lamictal (Lamotrigine)
      • Seroquel (Quetiapine)
      • Lithium
      • Depakote
      • Olanzapine (Zyprexa)
      • Risperidone (Risperdal)
      • Carbamazepine (Tegretol)
      • Lumateperone (Caplyta)
      • Cariprazine (Vraylar)
      • Brexpiprazole (Rexulti)
      • Lurasidone (Latuda)
      • Olanzapine/Samidorphan (Lybalvi)
  • Autism
    • Autism Treatment
    • ASD Medications
    • Autism Spectrum Rating Scale
    • SRS-2
  • Breathing
    • Journaling Benefits
  • Blog
  • CBT
    • CBTWorkbook
    • Cognitive Distortions
    • CBT Worksheets
  • Insurance
  • Narcissistic Abuse
    • Pathology of Narcissism
    • Covert Narcissistic traits
    • Brain Venn Diagram
    • Narcissist Red Flag Checklist
    • Partner Narcissistic Traits
    • Narcissist - short assessment
    • 1 ) Narcissistic Relationship Assessment
    • 2) Narcissistic Relationship Assessment
    • Trauma Education
    • Grounding Techniques
    • Breathing Technique
    • Trauma Worksheets
    • Trauma Assessments
    • PCL 5 Trauma Assessment
    • ACE Childhood Trauma
    • Dissociative Experiences Scale
    • Super Traits
    • Cognitive dissonance Checklist
    • Narcissistic Personality Inventory, NPI
    • Hypersensitive Narcissism Scale (HSNS)
    • Therapy for Narcissists
    • Therapist checklist
  • Contact

Lamictal (Lamotrigine)

Lamictal (Lamotrigine)

Mechanism of Action
​
Lamotrigine works primarily by:
  1. Inhibiting Voltage-Gated Sodium Channels:
    • Reduces the release of glutamate and aspartate, excitatory neurotransmitters involved in seizure generation and mood dysregulation.
  2. Stabilizing Neural Activity:
    • Prevents the abnormal, excessive firing of neurons that contributes to seizures and mood instability.
  3. Minimal GABAergic and Dopaminergic Interaction:
    • Unlike some anticonvulsants, Lamotrigine has limited effects on gamma-aminobutyric acid (GABA) or dopamine, which may reduce certain side effects associated with other medications.
Sources: Drugs.com, DrugBank, and NIH clinical summaries.


Picture
Clinical Benefits Lamotrigine is FDA-approved for:
  1. Epilepsy:
    • Treats focal and generalized seizures, including tonic-clonic and Lennox-Gastaut syndrome-related seizures.
  2. Bipolar Disorder:
    • Specifically effective in preventing depressive episodes in bipolar disorder. It is less effective for acute manic episodes, making it a preferred maintenance treatment.
Off-Label Uses:
  • May be used for borderline personality disorder, treatment-resistant depression, and certain pain syndromes.

DosageEpilepsy:
  • Starting Dose: 25 mg once daily for two weeks.
  • Maintenance Dose: 100–400 mg daily in divided doses, depending on response and other medications (e.g., enzyme-inducing drugs).
Bipolar Disorder:
  • Starting Dose: 25 mg daily for two weeks, followed by gradual titration.
  • Target Dose: Typically 100–200 mg daily.
Key Considerations:
  • Dosage adjustments are required if co-administered with enzyme-inducing (e.g., carbamazepine) or enzyme-inhibiting (e.g., valproate) drugs.
  • Slow titration minimizes the risk of severe rash, a well-known side effect.
Sources: FDA prescribing information, Drugs.com, and clinical guidelines.

Prevalence of Side EffectsCommon Side Effects (10–20% of users):
  • Headache, dizziness, ataxia (lack of muscle coordination).
  • Nausea, vomiting, and blurred vision.
Serious Side Effects (rare but significant):
  1. Skin Reactions:
    • Risk of Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN), particularly during rapid dose escalation.
    • Incidence: ~1 in 1,000 adults; higher in children.
  2. Hematological Effects:
    • Rare cases of blood dyscrasias, including aplastic anemia.
  3. Suicidal Ideation:
    • As with other antiepileptic drugs, there's a small increased risk of suicidal thoughts.
  4. Hypersensitivity Reactions:
    • Multi-organ hypersensitivity reactions (drug reaction with eosinophilia and systemic symptoms - DRESS) can occur.
  5. Neurological:
    • Rare reports of aseptic meningitis or movement disorders.
Sources: PubMed, NIH clinical databases, Drugs.com.
  • Home
  • Credentials
    • Published Articles
  • ADHD
    • Adult ADHD Self-Report Scale
    • ADHD Comprehensive Assessment
    • ADHD Management
    • ADHD Atypical Symptoms
    • ADHD Medications >
      • Adderall
      • Vyvanse
      • Methylphenidate
      • Concerta
      • Focalin (dexmethylphenidate)
      • Guanfacine (Intuniv)
      • Atomoxetine (Strattera)
      • Clonidine (Kapvay)
      • Onyda XR
      • Wellbutrin
      • Qelbree
      • Azstarys
      • Xelstrym
    • ADHD Medication for Anxiety >
      • Sertraline
      • Wellbutrin
      • Escitalopram (Lexapro)
      • Duloxetine (Cymbalta)
      • Venlafaxine (Effexor)
      • Buspirone (Buspar)
      • Fluoxetine (Prozac)
      • Paroxetine (Paxil)
      • Propranolol (Inderal)
      • Accutane - Adverse effects
    • Pomodoro Technique
    • ADHD Neurochemical
    • ADHD Worksheets
  • Anxiety
    • Insomnia
    • Sertraline
    • Buspirone (Buspar)
    • Fluoxetine (Prozac)
    • Effexor
    • Paroxetine (Paxil)
    • Escitalopram (Lexapro)
  • AUD
    • AUD Medications >
      • Naltrexone
      • Acamprosate
      • Disulfiram (Antabuse)
      • Topamax
      • Gabapentin
    • What to expect
    • Nutrition
    • Resources
    • Overcoming Shame
    • Health and Alcohol
    • AUD Videos
  • Bipolar
    • Bipolar Disorder Treament
    • Bipolar Disorder Worksheets
    • Bipolar Disorder Medications >
      • Abilify
      • Lamictal (Lamotrigine)
      • Seroquel (Quetiapine)
      • Lithium
      • Depakote
      • Olanzapine (Zyprexa)
      • Risperidone (Risperdal)
      • Carbamazepine (Tegretol)
      • Lumateperone (Caplyta)
      • Cariprazine (Vraylar)
      • Brexpiprazole (Rexulti)
      • Lurasidone (Latuda)
      • Olanzapine/Samidorphan (Lybalvi)
  • Autism
    • Autism Treatment
    • ASD Medications
    • Autism Spectrum Rating Scale
    • SRS-2
  • Breathing
    • Journaling Benefits
  • Blog
  • CBT
    • CBTWorkbook
    • Cognitive Distortions
    • CBT Worksheets
  • Insurance
  • Narcissistic Abuse
    • Pathology of Narcissism
    • Covert Narcissistic traits
    • Brain Venn Diagram
    • Narcissist Red Flag Checklist
    • Partner Narcissistic Traits
    • Narcissist - short assessment
    • 1 ) Narcissistic Relationship Assessment
    • 2) Narcissistic Relationship Assessment
    • Trauma Education
    • Grounding Techniques
    • Breathing Technique
    • Trauma Worksheets
    • Trauma Assessments
    • PCL 5 Trauma Assessment
    • ACE Childhood Trauma
    • Dissociative Experiences Scale
    • Super Traits
    • Cognitive dissonance Checklist
    • Narcissistic Personality Inventory, NPI
    • Hypersensitive Narcissism Scale (HSNS)
    • Therapy for Narcissists
    • Therapist checklist
  • Contact