100 MIgraine drugs, A to Z: lamotrigine

Lamotrigine (Lamictal) is an epilepsy drug that is also approved as a mood stabilizer in bipolar disorders. Its exact mechanism of action is not well understood.

There are no good controlled trials of lamotrigine in migraines, but an open long-term study by European neurologists suggests that 100 mg of lamotrigine is effective not only in reducing the frequency of migraines but also in reducing the frequency and the duration of visual auras. There are also case reports of lamotrigine relieving complicated auras with visual and sensory symptoms.

The main side effects of lamotrigine are dizziness, drowsiness, upset stomach, and rash. The rash can be serious and in very rare cases fatal (Stevens-Johnson syndrome), but it could be avoided by starting with a very low dose (25 mg) and increasing it by 25 mg every two weeks. For epilepsy, the dose goes up to as high as 600 mg a day.