Lamotrigine

Lamotrigine is an anticonvulsant drug commonly used to treat epilepsy and prevent seizures (since 1990), as well as in Lennox-Gastaut syndrome. As with a good number of drugs, over time it began to be used for other ailments that do not involve seizures. Due to its mood-stabilizing effect, it is also approved for the treatment of depression, more precisely bipolar disorder (2003).

Furthermore, this is not medical advice but only informative because I am not a doctor and have no experience with patients suffering from epilepsy. Just what I researched. Of course You can go to Wikipedia/Lamotrigine and do your own relsearch. But I'm going to write about what is important to me :)

Mechanism of action

Lamotrigine inhibits certain subtypes of voltage-gated sodium (Na+)-channels. It is assumed that it thus prevents the release of the 2 main excitatory neurotransmitters - glutamate and aspartate. It is also thought to block N-, L- and P-type calcium (Ca++)-channels, as well as to weakly inhibit certain serotonin (5-HT3) receptors.

These actions are thought to inhibit glutamate release in cortical projections in limbic areas of the ventral striatum. Its neuroprotective and antiglutamatergic effects have been highlighted as promising contributors to its mood-stabilizing activity.

Observations that lamotrigine reduces g-aminobutyric acid (GABA) receptor-mediated neurotransmission in the rat amygdala suggest that a GABAergic mechanism may also be involved. Lamotrigine does not appear to increase blood levels of GABA in humans.

When used for epilepsy

Lamotrigine can be used as monotherapy or as part of combination therapy. It is available for oral administration in plain tablets or chewable tablets.

The dose that is mainly tested in scientific works is around 400 mg, but the upper limit of 600 mg is also tested. Therefore, the recommended upper dose limit is somewhere around 400 mg per day. Of course, it typically starts at 25mg and slowly increases from week to week as needed up to 400 mg. Above 400mg, one should consider whether it is sufficient or whether the therapy should be changed. It all depends on the specialist epileptologist how he will coordinate the use of lamotrigine as monotherapy or as an addition to other drugs.

It should also be noted that lamotrigine does not interact (or minimally) with other drugs, since it often occurs in the treatment of epilepsy that anticonvulsant drugs interact with each other and can cause a worse effect. But again, you should consult your doctor.

Side Effects

It is important to note that lamotrigine requires careful dosing to reduce the risk of serious side effects, especially a rare but potentially life-threatening skin rash called Stevens-Johnson syndrome or toxic epidermal necrolysis. To mitigate this risk, the dosing schedule usually involves gradually increasing the dose over several weeks, following the instructions of the prescribing physician. 

The effectiveness and tolerability of lamotrigine may vary between individuals. Some people may experience a reduction in seizures and improved seizure control with minimal side effects. In some studies, doses as high as 600 mg within a week had no effects. But still, rare side effects of lamotrigine can include dizziness, headache, nausea, blurred vision, and skin rash (although severe rash is rare).

Compared to other anticonvulsant drugs, it can be said that it is one of the safer ones due to the rarity of nus phenomena. As with any medication, it is important to adhere to the prescribed dosage and follow the doctor's instructions regarding administration and potential interactions with other medications. Regular follow-ups are essential to assess response to treatment, adjust dosage if necessary, and address any concerns or side effects.

Overall, the effectiveness depends on the type of attack and the general health of the patient.

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...to be continued