Is it Safe to Discontinue Lamotrigine 150mg per Day for Depression Without Gradual Withdrawal?

Yes, I did stop taking Lamotrigine 150mg per day for depression suddenly in March 2020. At the time, my professional commitments interfered with my ability to be a mother, and despite the challenges, I eventually decided to stop the medication in January 2021. Tragically, this period also included the loss of a child to cancer, who passed away peacefully. I was fortunate to have a doctor who could manage her pain effectively, which brought some peace during a challenging time.

Why Abrupt Withdrawal is Generally Not Recommended

In general, it's not advisable to stop taking any psychiatric medication abruptly, especially if you've been on them for an extended period (e.g., 3 months or longer). This is because prolonged use often leads to neuroadaptive changes in the brain, which can result in withdrawal symptoms upon sudden discontinuation. These symptoms can be severe and include mood swings, irritability, anger, depression, fatigue, and headaches.

This applies to various psychiatric medications, including antidepressants, benzodiazepines, antiepileptic mood stabilizers, and antipsychotic medications. Lamotrigine, an antiepileptic mood stabilizer, is known to have a discontinuation syndrome that can include both mental and physical symptoms. Additionally, abruptly stopping an antiepileptic medication like Lamotrigine can potentially lead to a seizure, even if you have never had one before.

When Abrupt Withdrawal Might Be Appropriate

There are rare instances when stopping a medication abruptly is appropriate, such as in the case of an allergic reaction. Severe forms of drug-induced allergy associated with Lamotrigine include Stevens-Johnson Syndrome and DRESS (Drug Rash with Eosinophilia and Systemic Symptoms). If you experience any symptoms of these conditions, it's crucial to stop the medication immediately and seek medical attention.

Personal Experience and Advice

I personally quit Lamotrigine after decades of taking it, but it's crucial to taper off the medication gradually, especially if you've been on it for an extended period. Missing a few doses can lead to side effects such as headaches, sickness, and mood changes. In my case, stopping cold turkey caused no noticeable side effects, but that's not always the case. If you have a doctor, it's advisable to consult them before making any changes to your medication regimen.

Although I did not have a medical professional's guidance, I was aware of the importance of a gradual cessation and monitored for any side effects. Fortunately, I experienced no significant issues, and it has been almost a year since I discontinued the medication. The decision to start and stop Lamotrigine was ultimately the right choice for me, but everyone's experience is unique. Therefore, it's essential to proceed with caution and be prepared for potential withdrawal symptoms.