im considering trying this too,
see also from Maija's book:
lamotrigine (Lamictal, Elmendos)
Lamotrigine primarily works by binding to voltagesensitive sodi-
um channels and blocking excess glutamate release. It also binds to the
sigma receptors to some extent and weakly antagonizes the 5HT3 sero-
tonin receptors. It is a common treatment for bipolar disorder, especially
if depression predominates. It can be used to treat chronic pain, especi-
ally neuropathic pain, and may be useful in some refractory cases.
Lamotrigine improves the quality of sleep, especially by increasing the
amount of REM sleep.36
Perhaps owing to these multiple modes of action lamotrigine is a
medication that improves the condition of many CFS/ME patients. At
best the patient can reach almost full remission. The dose used to treat
CFS/ME varies from the 2550 mg used by Jay Goldstein up to 300
400 mg a day. Jacob Teitelbaum feels that doses below 200 mg a day
are not effective.37 Lamotrigine may be useful in PTSD38 and migraine,
especially migraine with aura.39 It also has some antiviral action against
HHV6.40
When using lamotrigine it is important to consider the possibility of
lifethreatening rash (StevensJohnson syndrome) and begin the treat-
ment with a very low dose which is slowly titrated up. One problem is
that up to 1/10 of patients get some kind of a rash from lamotrigine,
which is usually a harmless one without fever and other symptoms, but
often the medication is discontinued anyway. Most patients can continue
taking the drug if it stopped until the rash has healed and then reintrodu-
ced even more slowly.
Headache, dizziness and vision impairment are common side
effects when using larger doses. Nervousness, nausea, stomach upset,
drowsiness, insomnia, muscle aches and tremor are also seen fairly
often. Many other drugs can markedly either slow down or speed up the
metabolism of lamotrigine so one has to be careful when trying new
drugs, especially other anticonvulsants, when on lamotrigine. Acetami-
nophen (paracetamol) should not be used with lamotrigine.
Lamotrigine is widely available and the smallest tablets only con-
tain 5 mg of the drug. Different starting kits are also available.