In crisis? Call or text 988 or call 911. This practice does not provide emergency care.

Medication guide

Lamotrigine (Lamictal) for bipolar disorder: uses, side effects, and safety

Medically reviewed by Dr. Iman Yunis, DNP, PMHNP-BC · Last reviewed October 26, 2026

A plain-language guide to a mood stabilizer used to help prevent mood episodes in bipolar I disorder.

New patients typically seen within 2–3 days

  • ✓ Plain-language guide
  • ✓ Reviewed by a psychiatric NP
  • ✓ Not a substitute for medical advice

The short answer

Lamotrigine (Lamictal) is a mood stabilizer approved by the FDA to help prevent mood episodes in adults with bipolar I disorder, and it is especially helpful for preventing depressive episodes. It must be started at a low dose and increased slowly because of a rare but serious rash. Call your prescriber right away if you develop a rash.

Safety first

Before you read

Never start, stop, or change a medication on your own. Talk with your prescriber first. If you have thoughts of harming yourself, call or text 988 now, or call 911 in an emergency.
FDA boxed warning: Lamotrigine can cause serious, life-threatening skin rashes. The risk is higher if the starting dose is too high, the dose is increased too quickly, or it is taken with valproate. Serious rashes usually appear in the first 2 to 8 weeks but can happen at any time. Call your prescriber right away for any rash, blistering, peeling skin, hives, or sores in the mouth or eyes.

Uses

What lamotrigine is used for

Lamotrigine is an anticonvulsant and mood stabilizer. It is used to:

  • Help lengthen the time between mood episodes in bipolar I disorder (maintenance treatment)
  • Treat certain types of seizures in epilepsy

It does not treat an active episode of mania or depression that is already happening.

What to expect

How it works and how long it takes

Lamotrigine helps stabilize nerve activity in the brain. It is started at a low dose and increased slowly over several weeks, no faster than every 1 to 2 weeks. This slow start lowers the risk of a serious rash, so following the schedule exactly matters.

Side effects

Common side effects

These are often mild and may ease over the first few weeks. Tell your prescriber if they bother you or do not go away.

  • Dizziness, drowsiness, or headache
  • Blurred or double vision
  • Problems with balance or coordination
  • Nausea, diarrhea, or upset stomach
  • Trouble concentrating

When to call

Serious side effects: call your prescriber right away

  • Any rash, blistering, peeling skin, hives, or mouth or eye sores
  • Headache with fever, stiff neck, light sensitivity, or confusion
  • Unusual bleeding, bruising, or signs of infection
  • Seizures that are new, more frequent, or different
  • New or worsening depression, mood changes, or thoughts of self-harm

For signs of a severe allergic reaction, such as swelling of the face or throat or trouble breathing, call 911.

Cautions

Interactions and who should be careful

  • Valproate (Depakote, Depakene) raises lamotrigine levels and the risk of serious rash, so the dose schedule is different
  • Lamotrigine may make hormonal birth control (pills, patch, ring, injection) less effective; use a reliable backup method and tell your prescriber about any hormone changes
  • If you miss several days, do not restart at your usual dose; call your prescriber, because you may need to restart slowly
  • Children and teens are more likely than adults to develop serious rashes

Pregnancy and breastfeeding

If you are pregnant, planning pregnancy, or breastfeeding

Tell your prescriber if you are pregnant, planning pregnancy, or breastfeeding. Pregnancy can change lamotrigine levels, so close monitoring and planning with your prescriber and OB or midwife matter. Learn about our women’s mental health care.

Stopping

Stopping lamotrigine safely

Do not stop lamotrigine suddenly. Stopping abruptly can increase the risk of seizures and mood episodes. Your prescriber will lower the dose gradually if stopping is right for you, and you should not restart without their guidance.

Not working?

When a medication is not helping enough

If lamotrigine is not helping, is causing side effects you cannot tolerate, or has stopped working, a thorough review can help. Options may include adjusting the dose, switching medications, adding therapy, or GeneSight® testing to help guide choices.

Dr. Yunis offers medication reviews by video across Washington, and new patients are typically seen within 2–3 days.

FAQ

Common questions about lamotrigine

Why does lamotrigine have to be started so slowly?

A slow increase lowers the risk of a serious rash. Follow your prescriber’s schedule exactly and do not take extra doses.

Does lamotrigine cause weight gain?

Weight gain is not among the commonly listed side effects. Talk with your prescriber about any changes you notice.

What if I get a rash on lamotrigine?

Call your prescriber right away. Most rashes are not serious, but only a clinician can tell, and some rashes are dangerous.

Can I take lamotrigine with birth control?

Lamotrigine may make hormonal birth control less effective, and hormones can change lamotrigine levels. Discuss contraception with your prescriber.

Sources

Where this information comes from

This guide summarizes publicly available drug information from MedlinePlus (U.S. National Library of Medicine). It is general education, not medical advice, and does not cover every use, side effect, or interaction. Always follow the guidance of your own prescriber and pharmacist.

Want a second look at your medications?

Book a medication review by video. Most Washington insurance accepted.

Book a Visit
Text us Book a Visit
Scroll to Top