Is Lamotrigine a controlled substance?
By
Dr Milena Locci de Oliveira (PhD)
Author bio
Dr Milena Locci de Oliveira is a Pharmacist and Doctor of Philosophy in Sciences from the University of São Paulo (USP). She has experience in microbiology, analytical toxicology, and clinical pharmacokinetics. She writes and reviews content on these topics.
Dr Milena’s Highlights:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration in the areas of Pharmacometrics and Population Pharmacokinetics, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
“Science can be translated, and it is essential that everyone has access to quality information to make informed decisions” – Dr Milena Oliveira, PhD.
Professional Experience:
With a decade-long career as a researcher, Dr Milena has amassed extensive experience in conducting research projects in microbiology, analytical toxicology, and clinical pharmacokinetics.
Her expertise also extends to the preparation of technical and scientific reports, literature reviews, data analysis, and scientific communication, both oral and written.
Dr Milena has served as a Clinical Pharmacist, providing expert supervision and guidance to teams during the challenging times of the COVID-19 pandemic, particularly in the ICUs of two reference hospitals for patient hospitalization.
In her most recent role, Dr Milena worked on the implementation of the deliberatives of the São Paulo State Government Pharmaceutical Assistance Coordination. These decisions were aimed at ensuring medication access within the Unified Health System.
A widely multidisciplinary background enabled Dr Milena to become a professional capable of integrating scientific knowledge into private initiatives, education, and healthcare, delivering consistent services in patient safety and population health.
Professional Memberships & Affiliations:
Dr Milena Oliveira is a member of the Regional Council of Pharmacy of the State of São Paulo, Brazil.
Education:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
Relevant Published Work & Citations:
Oliveira ML de, Rocha A, Nardotto GHB, Pippa LF, Simões BP, Lanchote VL. Analysis of daunorubicin and its metabolite daunorubicinol in plasma and urine with application in the evaluation of total, renal and metabolic formation clearances in patients with acute myeloid leukemia. Journal of Pharmaceutical and Biomedical Analysis. Nov 2020. 191:113-124.
Abstracts. CPT: Pharmacometrics & Systems Pharmacology. 2020 Nov; 9 (S1).
Pippa LF, Oliveira ML de, Rocha A, de Andrade JM, Lanchote VL. Total, renal and hepatic clearances of doxorubicin and formation clearance of doxorubicinol in patients with breast cancer: Estimation of doxorubicin hepatic extraction ratio. Journal of Pharmaceutical and Biomedical Analysis. 2020 Jun 5; 185:113-231.
Godoy ALPC, De Jesus C, De Oliveira ML, Rocha A, Pereira MPM, Larangeira DF, Lanchote VL, Barrouin-Melo SM. Determination of Allopurinol and Oxypurinol in Dogs Plasma by High-Performance Liquid Chromatography with an Ultraviolet Detector: Application for Pharmacokinetic Studies. J Chromatogr Sep Tech. 2017; 8 (4).
Clímaco EC, Oliveira ML de, Pitondo-Silva A, Oliveira MG, Medeiros M, Lincopan N, et al. Clonal complexes 104, 109 and 113 playing a major role in the dissemination of OXA-carbapenemase-producing Acinetobacter baumannii in Southeast Brazil. Infection, Genetics and Evolution. 2013 Oct;19:127–33.
Conference Papers:
Oliveira, M. L.; NARDOTTO, G. H. B.; PIPPA, L. F.; ROCHA, A.; SIMOES, B. P.; LANCHOTE, V. L. . Daunorubicin metabolism and urinary excretion in patients with acute myeloid leukemia. In: 84th Annual Meeting of the German Society for Experimental and Clinical Pharmacology and Toxicology (DGPT) and the 20th Annual Meeting of the Association of the Clinical Pharmacology Germany (VKliPha), 2018, Göttingen. Naunyn-Schmiedeberg’s Arch Pharmacol, 2018. v. 391. p. S76-S76.
Oliveira, M. L.; NARDOTTO, G. H. B. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . The low contribution of urinary excretion in the elimination of daunorubicin and its metabolite daunorubicinol in patients with acute myeloid leukemia. In: 49th Brazilian Congress of Pharmacology and Experimental Therapeutics., 2017, Ribeirão Preto. Livro de Resumos, 2017. p. 64-64.
Oliveira, M. L.; PIPPA, L. F. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . Quantification of daunorubicin and its metabolite daunorubicinol in human plasma by LC-MS/MS. In: I International Meeting of Environmental Health and Toxicology (IMEHTOX), 2016, Ribeirão Preto. Livro de Resumos, 2016.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. . PFGE typing of Carbapenem-Resistant Acinetobacter baumannii isolated from different University Hospitals. In: V International Postgraduate and Research Symposium, 2012.
Clímaco, E.C. ; SILVA, A. P. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. Relação clonal entre linhagens de Acinetobacter baumannii produtoras de carbapenemases da família OXA em quatro hospitais no Brasil. In: XXI Latin American Congress of Microbiology, 2012, Santos. XXI Latin American Congress of Microbiology, 2012.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Darini A.L.C. . Dissemintion of OXA carbapenemases genes in carbapenem-resistant Acinetobacter baumannii in University Hospital of Juiz de Fora, MG. In: 8th CIFARP – International Congress of Pharmaceutical Sciences, 2011, Ribeirão Preto.
Clímaco, E.C. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Darini A.L.C. . Avaliação do sequenciamento parcial do gene rpoB e de seus flanqueadores para identificação de espécies de Acinetobacter na rotina laroratorial. In: 2° International Symposium on Clinical Microbiology, 2010, Florianópolis.
You can view some of Dr Milena’s work below and links to her professional profile.
Linkedin: https://www.linkedin.com/in/dra-milena-locci-de-oliveira-28986042/?locale=en_US
ResearchGate: https://www.researchgate.net/profile/Milena-Oliveira-6
Escavador: https://www.escavador.com/sobre/5394254/milena-locci-de-oliveira
Lattes: https://buscatextual.cnpq.br/buscatextual/busca.do
Scopus: https://www.scopus.com/authid/detail.uri?authorId=57199779361
Scholar: https://scholar.google.com/citations?view_op=list_works&hl=pt-BR&user=1YUBDIQAAAAJ
Is Lamotrigine a controlled substance?
No, Lamotrigine is not a controlled substance. It is an anticonvulsant medication and a mood stabiliser. Lamotrigine basically controls the irregular activity of chemicals or neurotransmitters in your brain that causes seizures and unusual mood changes (1).
Although it is not a substance of abuse, Lamotrigine is still prescribed carefully. This is because the Food and Drug Administration (FDA) has issued a warning against Lamotrigine that this medication hyperactivates the immune system or infection-fighting cells and causes severe inflammation all over your body (2).
This can lead to hospitalization and even death (2). However, this side effect is not that common but it’s difficult to predict who will be affected.
If your doctor has prescribed Lamotrigine and your body seems to adjust well to it, make sure you take it as properly as you can and don’t exceed the prescribed dosage strength and frequency.
How is Lamotrigine different from controlled substances?
While Lamotrigine affects the brain like controlled substances, there are some major points that differentiate it from those medications:
Therapeutic purpose
As stated earlier, Lamotrigine is prescribed for specific medical conditions like epilepsy and bipolar disorder (1,3), whereas controlled substances, such as opioids or stimulants, are typically prescribed for pain management, attention-deficit/hyperactivity disorder (ADHD), or other specific purposes (4).
Classification
Lamotrigine is classified as an antiepileptic or anticonvulsant medication. It is not categorized as a controlled substance by regulatory authorities (5).
Controlled substances, on the other hand, are medications that have the potential for abuse or addiction and are regulated due to their potential for misuse (4).
Abuse potential
Lamotrigine has a relatively low potential for abuse or addiction compared to controlled substances.
Controlled substances, by their nature, have a higher risk of abuse, dependence, and addiction due to their effects on the brain’s reward and pleasure centres. (4)
Prescription requirements
Lamotrigine is typically prescribed by healthcare providers and may require regular monitoring, dose adjustments, or gradual tapering off when discontinuing the medication (5).
Controlled substances often have stricter regulations and may require specialized prescriptions, more frequent monitoring, or specific dispensing procedures to prevent misuse (4).
It’s important to note that Lamotrigine, like any medication, should be taken as prescribed and under the guidance of a healthcare professional. It’s crucial to follow the prescribed dosage and not use it in a manner other than what was directed by your healthcare provider.
Can Lamotrigine negatively affect your health?
Lamotrigine, although it is not a controlled substance, can affect your health negatively by causing side effects (5).
Common side effects of Lamotrigine include:
- Headache
- Dizziness
- Drowsiness
- Nausea or vomiting
- Upset stomach or abdominal pain
- Diarrhoea
- Blurred or double vision
- Increased libido
- Skin rash (notably, it may be serious in some cases)
- Insomnia or difficulty sleeping
- Anxiety or irritability
- Fatigue or weakness
Rare but serious side effects (should be reported to a healthcare professional immediately):
- Allergic reactions (e.g., hives, itching, swelling, difficulty breathing)
- Stevens-Johnson syndrome (a severe skin reaction)
- Aseptic meningitis (inflammation of the protective membranes around the brain and spinal cord)
- Suicidal thoughts or behaviours
- Mood changes (such as depression, anxiety, and agitation)
- Persistent or severe headaches
- Unusual bleeding or bruising
- Signs of liver problems (e.g., yellowing of the skin or eyes, dark urine, abdominal pain)
- Changes in vision or eye problems
- Fever, sore throat, or other signs of infection
What to do if you are concerned about Lamotrigine-induced side effects?
If you have concerns about the side effects of Lamotrigine, it’s important to reach out to your healthcare provider. They are the best resource to help address your specific concerns and provide guidance.
Your healthcare provider will evaluate your individual situation and consider factors such as your medical history, other medications you may be taking, and the severity of the side effects.
They may adjust the dosage of Lamotrigine, suggest ways to manage the side effects or explore alternative treatment options if necessary. Remember, each person may react differently to medications, and what works for one person may not work the same way for another.
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References
1.-
Goa KL, Ross SR, Chrisp P. Lamotrigine. A review of its pharmacological properties and clinical efficacy in epilepsy. Drugs. 1993 Jul;46(1):152-76. doi: 10.2165/00003495-199346010-00009. PMID: 7691504. https://pubmed.ncbi.nlm.nih.gov/7691504/
2.-
The Food and Drug Administration, FDA. FDA warns of serious immune system reaction with seizure and mental health medicine lamotrigine. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-warns-serious-immune-system-reaction-seizure-and-mental-health
3.-
Goldsmith DR, Wagstaff AJ, Ibbotson T, Perry CM. Lamotrigine: a review of its use in bipolar disorder. Drugs. 2003;63(19):2029-50. doi: 10.2165/00003495-200363190-00009. PMID: 12962521. https://pubmed.ncbi.nlm.nih.gov/12962521/
4.-
Aro HJ, Hussain A, Bobrin BD. Controlled Substances. 2023 Apr 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 32119270. https://www.ncbi.nlm.nih.gov/books/NBK554383
5.-
Betchel NT, Fariba KA, Saadabadi A. Lamotrigine. 2023 Feb 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 29262021. https://www.ncbi.nlm.nih.gov/books/NBK470442