Research dating back to the 1920s has shown that diet can improve seizure control in people who have epilepsy. Although these studies are based on a strict diet called the ketogenic diet, recent evidence has shown that less restrictive diets may also be helpful. The modified Atkins diet and the Low Glycemic Index treatment are two such diets that have been studied.
However, some types of food can also worsen seizures by affecting the way your seizure medications work. Knowing the type of food that can affect your medication or how it works is a critical step in avoiding drug-food interaction and living a seizure-free life.
What Is Lamotrigine And What Does It Treat?
Lamotrigine is a mood stabilizer medication that works in the brain. It is approved for the treatment of bipolar disorder (also known as manic depression) and certain types of seizure disorders. Bipolar disorder involves episodes of depression and/or mania.
Symptoms of depression include:
• Depressed mood – feeling sad, empty, or tearful
• Feeling worthless, guilty, hopeless, or helpless
• Loss of interest or pleasure in normal activities
• Sleep and eat more or less than usual (for most people it is less)
• Low energy, trouble concentrating, or thoughts of death (suicidal thinking)
• Psychomotor agitation (‘nervous energy’)
• Psychomotor retardation (feeling like you are moving in slow motion)
Symptoms of mania include:
• Feeling irritable or “high”
• Having increased self-esteem
• Feeling like you don’t need to sleep
• Feeling the need to continue to talk
• Feeling like your thoughts are too quick (racing thoughts)
• Feeling distracted
• Getting involved in activities that are risky or could have bad consequences (e.g., excessive spending)
Lamotrigine may also be helpful when prescribed “off-label” for bipolar depression. “Off-label” means that it hasn’t been approved by the Food and Drug Administration for this condition. Your mental health provider should justify his or her thinking in recommending an “off-label” treatment. They should be clear about the limits of the research around that medication and if there are any other options.
How Should I Take Lamotrigine?
Lamotrigine is usually taken 1 or 2 times daily with or without food.
Typically, patients begin at a low dose of medicine and the dose is increased slowly over several weeks.
The dose usually ranges from 25 mg to 400 mg. Only your health care provider can determine the correct dose for you.
Extended-release tablets: Swallow whole. Do not crush, chew or split tablets.
Lamotrigine orally disintegrating tablets must remain in their original packaging. Open the package with clean dry hands before each dose. Do not try to put tablets in a pillbox if you take the orally disintegrating tablets. Lamotrigine orally disintegrating tablets will dissolve in your mouth within seconds and can be swallowed with or without liquid.
Use a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take your medication. You may also ask a family member a friend to remind you or check in with you to be sure you are taking your medication.
What Happens If I Miss A Dose Of Lamotrigine?
If you miss a dose of lamotrigine, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your health care provider. Do not double your dose or take more than what is prescribed. If you miss more than 3 days of medication, contact your prescriber because he/she may need to adjust your dose.
What Happens If I Overdose With Lamotrigine?
If an overdose occurs, call your doctor or 911. You may need urgent medical care. You may also contact the poison control center at 1-800-222-1222. A specific treatment to reverse the effects of lamotrigine does not exist.
How Long Does It Take For Lamotrigine To Work?
It is very important to tell your doctor how you feel things are going during the first few weeks after you start taking lamotrigine. It will probably take several weeks to see big enough changes in your symptoms to decide if lamotrigine is the right medication for you.
Mood stabilizer treatment is generally needed lifelong for persons with bipolar disorder. Your doctor can best discuss the duration of treatment you need based on your symptoms and illness.
What Should I Avoid While Taking Lamotrigine?
When taking lamotrigine avoid food that can spike or crash the levels of sugar in your bloodstream which could cause seizures According to the Epilepsy Foundation.
In general, you should avoid the following foods while taking lamotrigine:
Sugary Foods: Some people report that food additives like artificial sweeteners can trigger seizures, according to the Epilepsy Society. While more studies are needed to determine this relationship, there is some early research to suggest that artificial sweeteners like aspartame may make you more susceptible to seizures, per a May 2016 review in the Indian Journal of Pharmacology.
According to the Mayo Clinic, foods that contain artificial sweeteners include:
- Soda
- Candy
- Pudding
- Packaged baked goods
- Canned foods
- Jams and jellies
Caffeine-containing Foods: Caffeine stimulates your central nervous system, according to the Cleveland Clinic. And while more research is needed to better understand the connection between your nervous system, epilepsy, and caffeine, there is some evidence to suggest that caffeine may up the odds of having a seizure, according to the Epilepsy Society.
Consider limiting the following caffeinated beverages:
- Coffee
- Tea
- Soda
- Energy drinks
Foods with Saturated and Trans Fats: While healthy fats are a key part of a balanced diet, saturated and trans fats aren’t so good for you. They may increase your cholesterol levels and risk for heart disease, per the Cleveland Clinic.
The NIA thus recommends limiting the following sources of saturated and trans fats in favor of healthier options:
- Butter
- Margarine
- Beef fat
- Coconut, palm and palm kernel oils
- Processed foods like packaged cakes, cookies or frozen pizza
Alcohol and Illegal drugs: While taking lamotrigine, drinking alcohol or using illegal drugs may decrease the benefits (e.g., worsen your condition) and increase adverse effects (e.g., sedation) of the medication.
What Are The Possible Side Effects Of Lamotrigine?
Common side effects of Lamotrigine include:
• Nausea
• Insomnia
• Runny nose
• Non-serious rash
• Headache
• Diarrhea
• Abnormal dreams
• Dizziness or drowsiness
• Fatigue
Are There Any Risks For Taking Lamotrigine For Long Periods Of Time?
To date, there are no known problems associated with long-term use of lamotrigine. It is a safe and effective medication when used as directed.
It is important to note that some of the side effects listed above (particularly rash and suicidal thoughts) may continue to occur or worsen if you continue taking the medication. It is important to follow up with your doctor routinely and to contact your doctor immediately if you notice any skin rash or changes in mood or behavior.
What Other Medications May Interact With Lamotrigine?
The following medications may increase the level and effects of lamotrigine:
• Valproate/divalproex (Depakote®)
The following medications may decrease the level and effect of lamotrigine:
• Anticonvulsants such as phenytoin (Dilantin®), carbamazepine (Tegretol®/Carbatrol®/Equetro®), phenobarbital, and primidone (Mysoline®)
• Oral contraceptives (birth control pills)
• Rifampin (Rifadin®), ritonavir (Norvir®)
Lamotrigine may increase the level and effects of:
• Clozapine (Clozaril®, FazaClo®)
