- Lamotrigine is primarily an anticonvulsant and mood stabilizer, not FDA-approved specifically for anxiety, but may be helpful for anxiety linked to mood instability.
- Clinical evidence for lamotrigine's effectiveness in treating anxiety is limited but promising, especially in bipolar or treatment-resistant anxiety cases.
- Lamotrigine offers a lower risk of dependence compared to traditional anxiety medications like benzodiazepines, making it potentially useful for long-term management in certain patients.
Anxiety disorders affect millions of people and can seriously disrupt daily life. While treatments like therapy, SSRIs, and lifestyle changes work well for many, not everyone sees results. That’s why some clinicians are exploring other options—like lamotrigine.
Yes, the same medication used to treat epilepsy and bipolar disorder.
Understanding Anxiety Disorders
Anxiety shows up in many forms: Generalized Anxiety Disorder (GAD), Social Anxiety Disorder, Panic Disorder, and PTSD, to name a few. Common symptoms include chronic worry, restlessness, irritability, and sleep issues. Standard treatment often includes cognitive behavioral therapy (CBT), medications such as SSRIs or benzodiazepines, and practices like mindfulness or regular physical activity.
But when these don't fully work—or when anxiety coexists with mood instability—something else might be needed.
What Is Lamotrigine?
Lamotrigine (brand name Lamictal) is part of the anticonvulsant and mood stabilizer family. It’s FDA-approved for treating seizures and bipolar disorder, especially the depressive episodes common in bipolar type II.
Mechanistically, lamotrigine works by inhibiting voltage-sensitive sodium channels in the brain, which helps stabilize neuronal activity and reduces the release of excitatory neurotransmitters like glutamate.
Lamotrigine’s Role in Anxiety
While it’s not officially approved for anxiety disorders, lamotrigine is sometimes used off-label—particularly when anxiety is intertwined with mood symptoms. It's not a go-to option for primary anxiety disorders, but it becomes relevant when anxiety is part of a broader picture, such as bipolar depression or emotional dysregulation.
In these contexts, lamotrigine’s mood-stabilizing effects may help address both anxiety and underlying mood shifts.
What the Research Shows
Clinical evidence is still emerging. Small studies and anecdotal reports suggest that lamotrigine may help with anxiety in patients who also have bipolar disorder or other mood instability. For example, a study published in the Journal of Clinical Psychiatry reported improvements in anxiety symptoms when lamotrigine was added to a treatment plan for bipolar depression.
However, it’s not consistently effective when used alone for anxiety that doesn’t involve mood dysregulation. More robust, large-scale trials are needed to determine its full potential and limitations.