Expert: Ivan Goldberg, M.D. - 5/13/2008

Question
Hi, My husband was diagnosed with hypomania and was prescribed Lamectol. He is concerned with the long-terms side effets of the medication and I am concerned that once you start meds, you keep adding new meds on top of them to counter-act the side effects of the first meds. Do you have experience with patients taking Lamectol for over 15 years? once they find the right dose for them (and assuming they don't get a rash), do they stay on it for life without having to add new meds? do you know of any other long-term side effects? thanks in advance for answer.

Answer
Hi, Sabine,

Lamotrigine (Lamictal) was introduced into medical practice about 18 years ago and I have had patients take it continuously for 15 years. As yet there is not evidence of long-term toxicity.

It is seldom necessary to add other medications to Lamictal when it is used as a mood stabilizer. While the antidepressant effects of Lamictal are considerable, it is much less useful as a way of controlling hypomania. For that purpose I usually prescribe lithium, Tegretol, Depakote or Trileptal.

Best regards . . .

Ivan
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