From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
The acute deterioration in a person with HPPD who has been stable on Lamotrigine is most likely due to medication non-adherence, drug interactions, or environmental stressors, which can disrupt the steady blood levels of Lamotrigine and lead to symptom recurrence, as evidenced by the most recent study 1. The possible reasons for this deterioration can be broken down into several factors, including:
- Medication non-adherence, where the person has missed doses or stopped taking Lamotrigine, leading to decreased blood levels and symptom recurrence
- Drug interactions if the person has started new medications that affect Lamotrigine metabolism, such as certain antibiotics, anticonvulsants, or oral contracectives
- Environmental stressors, including major life changes, work pressure, or relationship problems, can also trigger symptom flare-ups despite stable medication
- Recent substance use, particularly psychedelics, cannabis, or stimulants, could exacerbate HPPD symptoms even with ongoing treatment
- Sleep disturbances or changes in sleep patterns may worsen visual disturbances and anxiety
- The person might be developing tolerance to their current Lamotrigine dosage, requiring adjustment It is essential to note that Lamotrigine works by stabilizing neuronal membranes through inhibition of voltage-sensitive sodium channels and modulation of glutamate release, so any disruption to steady blood levels or factors that counteract these mechanisms can lead to symptom recurrence, as discussed in 2 and 3. If symptoms persist beyond a few days, the individual should consult their healthcare provider promptly to evaluate these factors and potentially adjust treatment, considering the potential for lamotrigine toxicity, as highlighted in 4 and the importance of monitoring psychiatric symptoms, as discussed in 5.