What are the possible DISADVANTAGES of taking Lamotrigine?

Lamotrigine is not currently subsidised by the PBS (Pharmaceutical Benefits Scheme) for BPII, meaning that this medication costs more than some others available.

Short-term

  • It is unclear if lamotrigine is effective at preventing hypomanic/mixed episodes, meaning that you may need to take add-on medication/s to deal with these symptoms.
  • Within the first 2 months of starting lamotrigine, people may experience:
Benign (or non-serious) rash
8-9 in 100 people (8-9%)
Serious (Steven-Johnson’s like) rash.
1 in 10,000 to 1 in 1000 people (0.01-0.1%)

This rash requires hospitalisation and involves stopping medication. This rash is rare but can cause death (< 5 in 100 people who develop it and do not stop medication or receive proper treatment).

  • When starting lamotrigine, it may take 2-3 months to reach the working (therapeutic) dose. Dose increases need to be done slowly to avoid developing rash.
  • Within the first 4 months of taking lamotrigine, people may experience side effects, such as headache, nausea/vomiting, infection and dizziness.

In the first 2 months of starting lamotrigine, it is important to remain alert as most rashes develop during this time.

If you notice any signs of a rash, don’t take your next dose of lamotrigine and immediately contact your GP or psychiatrist for consultation. This may help you to avoid the complications associated with serious rash.

Mid-term

  • Within the first 18 months of taking lamotrigine to prevent relapse, people can commonly also experience:
Headache
18 in 100 people (18%)
Nausea/vomiting
17 in 100 people (17%)
Infection
12 in 100 people (12%)
Dizziness
8 in 100 people (8%)
For most people, side effects in the medium term are mild to moderate in intensity and do not stop them taking lamotrigine.