Lamictal and Hot Flashes
Lamictal (lamotrigine) does not cause hot flashes. There is no evidence in the medical literature linking lamotrigine to hot flashes as a side effect.
Evidence Review
The provided evidence extensively discusses hot flash management with various medications including:
- Gabapentin - reduces hot flashes by 46% at 900 mg/day 1
- Venlafaxine - reduces hot flashes by 61% at 75 mg/day 1
- SSRIs (paroxetine, citalopram) - reduce hot flashes by 50-65% 1
- Clonidine - reduces hot flashes by up to 46% 2, 3
Lamotrigine is notably absent from all hot flash treatment guidelines and research. The only mention of lamotrigine in the evidence relates to psychiatric side effects (affective switches, psychotic episodes, hallucinations) in patients using it for epilepsy or bipolar disorder 4.
Clinical Context
Hot flashes are primarily associated with:
- Menopausal status - hormonal changes 1
- Breast cancer treatments - particularly tamoxifen use, which causes hot flashes in 81% of patients 1
- Premature menopause from cancer treatments 5
Lamotrigine is an anticonvulsant and mood stabilizer used for epilepsy and bipolar disorder maintenance 4. Its known side effect profile includes psychiatric symptoms, not vasomotor symptoms like hot flashes 4.
Important Distinction
If a patient on lamotrigine is experiencing hot flashes, investigate other causes rather than attributing them to the medication:
- Menopausal status
- Concurrent medications (especially tamoxifen or aromatase inhibitors)
- Other medical conditions affecting thermoregulation
The hot flashes are coincidental to lamotrigine use, not caused by it.