Bipolar Happens Blog – Julie Fast

Here is a great question from a reader – Amy- regarding Lamictal (Lamotrigine) side effects.

My 18 year old son with BP, anxiety, depression, OCD, ADD tried Lamictal from March to June of this year and once he got above the 100 mg. mark he developed facial tics (squeezing his eyelids shut and mouth grimaces). We went off Lamictal gradually for about one month, and the facial tics disappeared. He had about 3 weeks completely off, then on the advice of Dr. Papolos (author of The Bipolar Child), we started up again and he is on 25 mg./day. So far, so good. But that dose is really equivalent to 50 mg/day because he takes 1500 mg. Depakote as well, and Depakote intensifies the Lamictal in the blood.

Has anyone else experienced facial tics with Lamictal? Dr. Papolos as well as my son’s current pdoc had never heard of that, but a friend who researched drug interactions/side effects on line did come up with 5 cases that have been reported.

Hi Amy,

I love questions that I can answer from personal experience.

I’ve been on Lamictal since 2005. It has saved my life numerous times. I call it my wonder drug- but this doesn’t mean it’s side effect free!

You can definitely have tics with Lamictal. I have them all of the time. Sometimes they are so bad they’re comical. I can practically jerk and twitch myself out of a chair. As awful as it can be, it can really make my mom laugh!

I even have one that makes me tap my cheek a few times after my body has jerked around. That one is weird.

Lamictal is an anti- epileptic drug. It’s powerful and it affects our brains. It makes sense it would have physical side effects such as controlling our muscle movement.

Dr. Papolos was completely correct about dosage. I only have these tics when my dosage is not correct. I’m the opposite from your son. I get the tics- I call them twitching- when my dose is too low. I always know if I’ve made a mistake with my meds when I start to twitch all over the place.  Messing with my meds can also cause some serious leg pain similar to restless leg syndrome.

I take 500 mg of Lamictal – 200 mg in the morning and 300mg at night. I have to put them in dated pill boxes as missing a dose is really painful for me mentally and physically.

I believe in the comprehensive treatment of bipolar disorder- I use my Health Cards and my Lamictal to have a functioning life. It’s a fact of life that these strong meds come with side effects- I try to minimize them as much as possible.

In terms of five cases being reported- this is not uncommon. Thousands and thousands can have Lamictal side effects that go unreported- as there is no place to report them unless we are in a study.

Your son is lucky to have you Amy! I hope he does really well on the new dose.

Julie