From the Research
Lamictal (lamotrigine) can rarely cause neutropenia, which is a decrease in neutrophils, a type of white blood cell important for fighting infections. This is considered an uncommon but serious side effect of the medication. The risk of neutropenia with Lamictal appears to be highest during the first few months of treatment, particularly during the initial titration period. Patients taking Lamictal should be aware of symptoms that might indicate neutropenia, such as fever, sore throat, mouth ulcers, or unusual infections. Regular blood monitoring is not routinely required for all patients on Lamictal, but may be recommended for those with risk factors or concerning symptoms. The mechanism behind lamotrigine-induced neutropenia is thought to be immune-mediated, where the drug or its metabolites trigger an immune response against neutrophils. If neutropenia is suspected, prompt medical evaluation is necessary, and the medication may need to be discontinued. Other medications that may increase the risk when combined with Lamictal include valproate and carbamazepine. Patients with a history of hematological reactions to other medications may be at higher risk.
Key Points to Consider
- Neutropenia is a rare but serious side effect of Lamictal, and patients should be monitored for symptoms such as fever, sore throat, and mouth ulcers.
- The risk of neutropenia is highest during the first few months of treatment, particularly during the initial titration period.
- Regular blood monitoring is not routinely required, but may be recommended for patients with risk factors or concerning symptoms.
- The mechanism behind lamotrigine-induced neutropenia is thought to be immune-mediated.
- If neutropenia is suspected, prompt medical evaluation is necessary, and the medication may need to be discontinued.
According to the most recent study 1, there is substantial evidence for the efficacy of lamotrigine in bipolar disorder, specifically as add-on treatment during acute depressive episodes and as maintenance treatment for preventing relapse and recurrence. However, this study does not provide information on the risk of neutropenia associated with lamotrigine. Another study 2 provides information on the safety and tolerability of lamotrigine, but does not specifically mention the risk of neutropenia. Overall, the risk of neutropenia associated with lamotrigine is considered rare but serious, and patients should be monitored for symptoms and risk factors.