| Status Epilepticus (Epilepsy)
| Coma management
| Epilepsy - General Management
| First Seizure
| Epilepsy in Pregnancy
| Febrile seizures
Caution: stop if rash, anaemia, bruising, fever, lymphadenopathy, sore throat - seek medical help. Start slow reduces the risk of severe rash
- Indirectly decreases glutamate release
- Partial seizures, Primary generalised tonic-clonic
- Epilepsy, juvenile myoclonic epilepsy
- Secondary generalised tonic-clonic, Mood stabiliser
- Lamotrigine 25 mg PO alt. days week 1-2 and then 25-50 mg/day every 2 weeks.
- Maintenance: Lamotrigine 200 mg/d (max 500 mg).
- Doses of up to 500 mg daily have been used. Specialist use only advised
- Can raise level of carbamazepine
- Interactions with valproate which increases lamotrigine.
- Liver enzyme induces lower lamotrigine levels
- Rash common if dose increased quickly or on Valproate.
- Half the dose if on Valproate, increase the dose with Phenytoin and Carbamazepine.
- Skin rash, which generally appears within 8 weeks of starting treatment and resolves on withdrawal. STOP as can become Stevens-Johnson or Toxic epidermal necrolysis.
- Drowsiness, anxiety, diplopia, dizziness, headache, insomnia
- Tiredness, fever, agitation, confusion and hallucinations.
- Fall in Hb, WCC, platelets due to Bone marrow suppression - STOP