Nausea lamotrigine

Side effects. The most common side effects are headache, nausea and vomiting, diplopia, dizziness, ataxia and tremor. There are also reports that lamotrigine can cause such psychiatric side effects as aggression, agitation, confusion, hallucinations and psychosis, some of these effects possibly being associated with a reduction in the glutamatergic system. Rashes are a frequent side effect, occurring in up to 5% of patients. Usually rashes are mild but occasionally can be severe and amount to a Stevens-Johnson syndrome. The severe rash occurs more commonly in children. 

A 36-year-old woman with rapid-cycling bipolar II disorder and premenstrual mood exacerbation was treated as an out-patient with lamotrigine 400 mg/day, clonazepam 0.5 mg tds, and quetiapine 100 mg/day. She gained 9 kg in 6 months and was advised to reduce the dose of quetiapine to 50 mg/day. After 1 day, she reported nausea, dizziness, headache, and anxiety severe enough to preclude normal daily activities. She was instructed to take quetiapine 75 mg/day, but her symptoms continued and only resolved when she took 100 mg/day. Slower reduction in the dose of quetiapine (by 12.5 mg/day every 5 days) with an antiemetic, ondansetron, also failed. On a third attempt, prochlorperazine successfully reduced her withdrawal symptoms, although moderate nausea persisted for 2 days after complete withdrawal. 

Lamotrigine has been nsed as maintenance monotherapy for rapid-cycling bipolar disorder in 324 patients (open label) and 182 patients (donble-bUnd) with rapidcycling bipolar disorder (5). In aU, 265 patients reported adverse events during the open phase. The most common adverse events (over 10%) were headache, infection, influenza, nausea, abnormal dreams, dizziness, and rash. During the donble-bUnd phase 122 patients reported adverse events, eqnaUy with lamotrigine and placebo. 

In 126 patients with carbamazepine-resistant or valproate-resistant epilepsy given lamotrigine, 50% during add-on therapy and 53% during lamotrigine monotherapy had at least 50% reduction in total seizures (15). There were adverse events in 49 patients, including respiratory tract infections n — 11), dizziness (n — 8), headache (n = 7), diplopia (n = 5), tremor (n = 5), somnolence (n — 4), insomnia (n = 4), nausea (n — 4), and weakness (n = 3). Treatment was discontinued in nine patients because of adverse events, in five cases because of rash. 

The effects of overdosage of lamotrigine include sedation, ataxia, diplopia, nausea, vomiting, hypertonia, nystagmus, and prolongation of the QRS complex (SEDA-18, 66). Cardiac rhythm should be monitored. Multiple oral dosing with activated charcoal enhances lamotrigine elimination, but its value in overdose is unknown. 

Dizziness, ataxia, diplopia, blurred vision, nausea, and vomiting are signs of toxicity that occur when the blood level exceeds 10 Ug/mL. A chromatographic method for analysis of lamotrigine has been reported. ... 

TOXICITY Common adverse effects when lamotrigine is added to another antiseizure drug are dizziness, ataxia, blurred or double vision, nausea, vomiting, and rash. A few cases of Stevens-Johnson syndrome and disseminated intravascular coagulation have been reported. The incidence of serious rash in children (-0.8%) is higher than in adults (0.3%). 

Lamotrigine is reported to be generally well tolerated in maintenance studies, with the most common adverse events being headache, nausea, insomnia, and, to a lesser extent, tremor. Incidences of diarrhea and tremor are lower with lamotrigine than with litbium. 

Lamotrigine 22-36 h 200-500 mg Lethargy, dizziness, ataxia, stupor, nystagmus, hypertonia, seizures QRS prolongation nausea and vomiting hypokalemia hypersensitivity fever, rash (Stevens-Johnson syndrome) hepatitis, renal failure. 

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