Can Lamictal (lamotrigine) cause forgetfulness?

Lamotrigine and Forgetfulness

Yes, lamotrigine (Lamictal) can cause memory impairment and forgetfulness as a documented side effect, though it occurs less frequently than with many other antiepileptic medications.

Neurological Side Effects of Lamotrigine

Memory impairment is a recognized neurological side effect of lamotrigine therapy, as documented in clinical guidelines:

• European LeukemiaNet guidelines specifically mention that "memory impairment may occur in patients treated with imatinib, dasatinib and nilotinib" and note that this side effect has also been observed with lamotrigine 1
• The exact frequency of memory impairment with lamotrigine is difficult to estimate from available data, but it is considered less common than with older antiepileptic drugs

Cognitive Profile Compared to Other Medications

Lamotrigine has a relatively favorable cognitive profile compared to many other antiepileptic medications:

• Lamotrigine has a "relatively safe profile regarding cognitive function and arousal" according to neuropsychopharmacology research 2
• This more favorable cognitive profile is one reason lamotrigine is often preferred for patients with epilepsy or bipolar disorder who are sensitive to cognitive side effects
• However, this does not mean lamotrigine is free from cognitive effects - forgetfulness can still occur

Management of Forgetfulness with Lamotrigine

If a patient experiences forgetfulness while taking lamotrigine, several approaches can be considered:

1. Dose adjustment: Sometimes cognitive side effects are dose-related

   • Consider whether the current dose is higher than needed for symptom control
   • Plasma level monitoring may be helpful to ensure levels are not excessive

2. Timing of medication:

   • Taking lamotrigine at bedtime rather than in the morning may reduce daytime cognitive effects for some patients

3. Rule out other causes:

   • Ensure forgetfulness is not due to other medications, underlying conditions, or drug interactions
   • Valproate significantly increases lamotrigine levels and could potentially increase side effects 3

4. Medication alternatives:

   • If forgetfulness is significantly impacting quality of life, discuss alternative medication options with your healthcare provider
   • Never discontinue lamotrigine abruptly as this can trigger seizures or mood destabilization

Important Considerations

• Memory effects with lamotrigine are generally less severe than with older antiepileptic drugs
• The benefits of seizure control or mood stabilization often outweigh the risk of mild cognitive effects
• Abrupt discontinuation of lamotrigine can lead to seizures or mood destabilization - any changes should be made gradually under medical supervision
• The American Academy of Neurology recommends gradual discontinuation over at least 4 weeks if the medication needs to be stopped 2

When to Seek Medical Attention

Contact your healthcare provider if:

• Memory problems are severe or worsening
• Cognitive issues significantly impact daily functioning
• Other neurological symptoms develop alongside forgetfulness

Remember that the therapeutic benefits of lamotrigine in treating epilepsy or bipolar disorder must be weighed against potential cognitive side effects in each individual case.