Side Effects of Lamictal to Be Aware of

Key Takeaways

• Lamictal treats epilepsy and bipolar disorder, but can cause side effects ranging from mild nausea to rare, serious skin reactions.
• Common Lamictal side effects like drowsiness and dizziness typically resolve within days to weeks as your body adjusts to the medication.
• Severe reactions require immediate medical attention, including certain rashes, fever with stiff neck, or breathing difficulties.

Lamictal (lamotrigine) is an anticonvulsant or seizure medicine prescribed to treat symptoms of epilepsy and as a maintenance treatment for bipolar disorder, particularly depressive episodes. In the U.S., it’s commonly prescribed as a long-term mood stabilizer because it helps regulate abnormal electrical activity in the brain.

Like most medications, lamotrigine side effects are possible. Many are mild and temporary, but some can be serious and require urgent care. Understanding how common these effects are and what to watch for can help you use this medication safely. If you have questions, make sure to discuss them with the doctor prescribing the medication.

What are the Most Common Side Effects of Lamictal?

You should always be aware of the side effects of Lamictal or any drug you're starting. Lamictal is fast-acting, and most side effects are mild, often appearing early in treatment and improving within a few days to a few weeks as your body adjusts.

According to FDA prescribing information, the most common lamotrigine side effects are identified from clinical trials and vary by condition, but several occur in at least 5–10% of patients and more often than placebo.

These include:

• Dizziness (~38%)
• Headache (~29%)
• Diplopia, or double vision (~28%)
• Ataxia, or loss of coordination (~22%)
• Vomiting (~20%)
• Nausea (~19%)
• Blurred vision (~16%)
• Somnolence, or drowsiness (~14%)
• Rash (~10%)

Note: This list is not all-inclusive.

In bipolar disorder trials, insomnia (~10%) and dry mouth were also reported.

Lamictal reaches peak levels in the bloodstream within about 1.4 to 4.8 hours after a dose, and its effects can last over 24 hours. The side effects are most likely to occur early in treatment or during dose increases, which is why Lamictal is started at a low dose and increased slowly. Many mild symptoms improve as the body adjusts, but any rash should be evaluated promptly due to the risk of serious reactions.

What Less Common Lamictal Side Effects Should You Watch For?

According to the FDA, less common side effects of lamotrigine were reported at lower frequencies in clinical trials and postmarketing data. While less frequent, they can still impact daily functioning and should be monitored.

Here are some less common side effects of Lamictal:

Neurological symptoms

• Tremor
• Amnesia
• Abnormal thinking
• Nystagmus (rapid, repetitive eye movements)

Psychiatric symptoms

• Anxiety
• Depression
• Irritability
• Rapid, uncontrollable shifts in mood

Systemic reactions

• Infection
• Pain
• Flu-like symptoms
• Gastrointestinal issues like diarrhea or constipation

Note: This list is not all-inclusive.

These effects may emerge during dose adjustments or ongoing treatment, particularly if the medication interacts with other drugs or underlying conditions. Persistent or worsening symptoms should be discussed with your doctor to determine whether dose changes or alternative treatments are needed.

What Serious Lamictal Side Effects Require Immediate Care?

Occasionally, some, though not many, people will have Lamictal (lamotrigine) side effects that are more serious. While rare, it's important to know about the following potential side effects, as some can be life-threatening.

"In case of a fever, muscle stiffness, sore throat, dizziness or fatigue, inform your doctor immediately."

– Talkspace psychiatrist Dr. Muhammad Munir, MD

Call your doctor or 911, or go to the nearest emergency room immediately if you experience:

• Severe or spreading rash
• Swelling of the face, lips, or throat
• Difficulty breathing or swallowing
• Persistent fever with stiff neck or sensitivity to light
• Yellowing of the skin or eyes (jaundice)
• Severe confusion or neurological symptoms
• Thoughts of suicide or self-harm

These symptoms may signal a serious reaction and should never be ignored. Early treatment can significantly reduce complications.

Here are some conditions that can develop as a Lamictal side effect where immediate care may be required:

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)

Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare but serious skin conditions most often caused by medications like Lamictal.

Research in the International Journal of Case Reports and Images found that these skin syndromes result from the body being unable to detoxify drugs it sees as foreign. In response, cytotoxic T cells attack the skin's mucosa and epidermis layers.

Aseptic meningitis

The FDA notes that while Lamictal-associated aseptic meningitis isn't common, it is a serious potential side effect that causes symptoms like fever, headache, chills, stiff neck, abnormal sensitivity to light, confusion, and more. Symptoms have been reported to

occur within 1 day to one and a half months following the initiation of treatment.

Angioedema

Angioedema, or a hive-like swelling beneath the skin, is a noted skin reaction that an overdose of Lamictal might cause. This rare skin reaction can lead to anaphylaxis in some cases, causing severe swelling throughout the airways and lungs.

Hemophagocytic lymphohistiocytosis (HLH)

In a study published in the Journal of Clinical Pharmacy and Therapeutics, hemophagocytic lymphohistiocytosis (HLH) results from an adverse reaction to Lamictal. HLH is a very serious, almost always fatal, hyper-inflammatory condition that causes multiorgan failure. In the most severe cases, it can cause death.

If you have any of the following symptoms after taking Lamictal, you should get medical attention as soon as possible:

• Swollen lymph nodes
• Jaundice
• Enlarged liver
• Difficulty breathing or lung issues, such as coughing
• Nervous system issues — headache, visual disturbance, weakness, trouble walking

Suicidal thoughts or actions

According to research in Mental Health Clinician, Lamictal and other antiepileptic drugs can increase the risk of suicidal thoughts or actions. If you're experiencing increased suicidal thoughts, it's essential that you immediately reach out to your doctor or go to the nearest medical facility.

Severe allergic reaction

Severe allergic reactions (also known as anaphylaxis) are associated with Lamictal and can cause:

• Sudden swelling of the mouth, lips, tongue, or throat
• Tightening in the throat, difficulty swallowing, and a feeling of sore throat
• Difficulty breathing
• Suddenly feeling extreme confusion, dizziness, or drowsiness
• Skin or lips and tongue turning gray, blue, or pale

Multiorgan hypersensitivity reactions

Studies in Cutaneous Drug Eruptions linked Lamictal to drug-induced delayed multiorgan hypersensitivity syndrome (DIDMOHS) in about 1 out of every 300 adults. This is a rare but potentially fatal reaction caused by some drugs. The most common symptoms are a skin rash and fever.

"In case of a rash, inform your doctor urgently, and if possible, get it checked as soon as possible."

– Talkspace psychiatrist Dr. Muhammad Munir, MD

How Long Do Lamictal Side Effects Typically Last?

Most Lamictal side effects are mild and tend to appear early in treatment or during dose increases, when your body is still adjusting to the medication. While the FDA prescribing information does not specify exact timelines, many commonly reported effects improve over time as treatment stabilizes.

Typical Lactimal affect time of common side effects:

If side effects persist, worsen, or interfere with daily functioning, it’s important to talk to your doctor. They may adjust your dose or recommend alternative options to better support your treatment.

“Common side effects of nausea, headache, and upset stomach subside after a few days.”

– Talkspace psychiatrist Dr. Muhammad Munir, MD

How Should I Use This Medication?

Lamictal is typically started at a low dose and gradually increased over several weeks to reduce the risk of side effects. This process helps your body adjust safely.

Take your medication exactly as prescribed, at the same time each day. Do not change your dose without consulting your doctor. If you’re taking it for bipolar disorder, long-term use may be recommended to prevent symptom recurrence. Since lamotrigine can cause drowsiness or dizziness, avoid driving or operating machinery until you know how it affects you.

What Special Precautions Should I Follow?

Before starting Lamictal, tell your doctor about your full medical history and any medications you’re taking, as drug interactions and underlying conditions can affect how this treatment works. You should inform your provider if you:

• Have liver or kidney conditions, as dose adjustments may be needed
• Are pregnant, planning pregnancy, or breastfeeding
• Take hormonal birth control or other prescription medications, which may affect lamotrigine levels

Lamictal can cause side effects like dizziness or drowsiness, so use caution with activities that require alertness. Alcohol may increase these effects and should be used cautiously. Do not stop taking Lamictal suddenly without medical supervision, as this may increase the risk of seizures or mood symptom recurrence.

How Can You Manage Lamictal Side Effects Safely?

Most Lamictal side effects, especially those that are mild, don't require any medical attention and will go away as you adjust to taking the medication. If they're bothering you, though, try these strategies:

Taking the medication:

• Take with food if Lamictal upsets your stomach (helps reduce nausea and GI distress)
• Take exactly as prescribed (consistency maintains stable blood levels)
• Split your daily dose if drowsiness is problematic (spreads the sedating effect)

Lifestyle adjustments:

• Stay well hydrated (supports kidney function and drug metabolism)
• Eat healthy, balanced meals (stabilizes blood sugar and reduces nausea)
• Avoid alcohol and marijuana (can intensify drowsiness and dizziness)

Safety measures:

• Do not suddenly stop taking this medication (can trigger seizures or mood instability)
• Report persistent side effects to your doctor (may need dose adjustment)

"Do not stop the medication cold turkey, as that can be very dangerous, depending on the dose of the medicine."

– Talkspace psychiatrist Dr. Muhammad Munir, MD

Explore Whether Lamictal is Right for You with Talkspace

Lamictal is commonly prescribed for bipolar disorder and epilepsy, but determining whether it's the right fit depends on your unique health history and needs. Whether you're weighing therapy vs. medication or simply exploring your options, a Talkspace psychiatric provider can walk you through everything, answer your questions, and help you make an informed decision from the comfort of home.

No long wait times, no unnecessary office visits. Just straightforward, personalized psychiatric care when you need it most. If you are curious about Lamictal or looking to explore your treatment options, Talkspace makes it simple to get started.

Frequently Asked Questions (FAQs)

What should I do if I miss a dose of Lamictal?

If you miss a dose of Lamictal, take it as soon as you remember, unless it is almost time for your next dose. Do not double up to make up for the missed dose—just continue with your regular schedule and consult your doctor or pharmacist if you're unsure.

Can Lamictal cause weight gain or loss?

Lamictal (lamotrigine) is generally considered weight-neutral for most people, meaning it typically does not cause significant weight gain or loss. However, individual responses can vary, so it’s important to monitor any changes and discuss concerns with your healthcare provider.

Is it safe to drink alcohol while on Lamictal?

It’s generally not recommended to drink alcohol while taking Lamictal, as alcohol can increase side effects like dizziness, drowsiness, and impaired coordination. Drinking may also affect seizure control in people taking Lamictal for epilepsy, so it’s best to discuss alcohol use with your healthcare provider.

Does Lamictal interact with birth control pills?

Yes, some hormonal birth control methods can interact with Lamictal. Certain estrogen-containing contraceptives may reduce Lamictal levels in the blood, potentially making it less effective, so it’s important to talk to your healthcare provider about the best birth control options while taking Lamictal.

How is Lamictal different from other mood stabilizers?

Lamictal (lamotrigine) differs from other mood stabilizers, as it is particularly effective at preventing depressive episodes in bipolar disorder, rather than treating mania. It also tends to have a more favorable side effect profile, with less risk of weight gain or sedation compared to many other mood stabilizers.

Sources

1. U.S. Food and Drug Administration. Lamictal (lamotrigine) tablets, chewable dispersible tablets, and orally disintegrating tablets: prescribing information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/020241s045s051lbl.pdf 2015;—. Accessed April 21, 2026.
2. Reddy S, Puri S. Lamotrigine-induced Stevens–Johnson Syndrome: A clinical report. Int J Case Rep Images. 2020;11. doi:10.5348/101175z01sr2020cr. https://www.ijcasereportsandimages.com/archive/article-full-text/101175Z01SR2020. Accessed February 24, 2024.
3. Wang C, Fan Z, He Y, Fang W, Sun W, Li Z. Analysis of the clinical characteristics of lamotrigine‐induced haemophagocytic lymphohistiocytosis. Journal of Clinical Pharmacy and Therapeutics. 2022;47(6):745-751. doi:10.1111/jcpt.13602. https://pubmed.ncbi.nlm.nih.gov/35023173. Accessed February 24, 2024.
4. Caley CF, Perriello E, Golden J. Antiepileptic drugs and suicide-related outcomes in bipolar disorder: A descriptive review of published data. Mental Health Clinician. 2018;8(3):138-147. doi:10.9740/mhc.2018.05.138. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6007633/. Accessed February 24, 2024.
5. Klimas N, Quintanilla-Dieck J, Vandergriff T. Drug-induced delayed multi-organ hypersensitivity syndrome. Cutaneous Drug Eruptions. Published online 2015:271-279. doi:10.1007/978-1-4471-6729-7_25. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7122205/. Accessed February 24, 2024.

Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards.

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