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CBD vs. Lamictal for Seizures & Bipolar Disorder: About Interactions & Better Options

Lamotrigine, sold under the brand name Lamictal, is an anti-epileptic (AED) and anti-convulsive medication, prescribed as a standalone or supplementary medication, for treating and controlling epileptic seizures and bipolar disorder.

Studies indicate that Lamictal restores the balance of the natural substances in the brain and slows down the electrical signals that otherwise go on overdrive or trigger brain signals that have completely stopped during seizures or extreme mood swings. This helps reduce the intensity and frequency of seizures as well as keeps mood swings under control.

There is also some evidence of lamotrigine having clinical efficacy in certain neuropathic pain treatments.

Due to its mood-stabilizing properties, physicians prescribe lamotrigine to control and avert extreme mood swings of bipolar affective disorder (BPAD) and borderline personality disorder (BPD).

Studies mostly indicate that Lamictal is a safe and effective anti-convulsive supplement for both unipolar and bipolar depression, as well as rapid cycle manic-depression. There is also evidence of lamotrigine helping patients with Lennox-Gastaut syndrome and related epilepsy syndromes.

However, patients have often encountered quite a few adverse events, including some serious, life-threatening side-effects.

Lamictal’s Safety Issues Causing Concern Among Patients

Like most pharmaceutical drugs, Lamictal, too, has several side-effects. While some are benign, such as dizziness, lethargy, nausea, and headaches, others may be much more critical. These vary from increased sensitivity of muscles and sensory nerves and jaundice to lethal skin rashes, suicidal behavior, and even sudden unexplained death.

Even the US Food and Drug Association (FDA) had warned that lamotrigine use “can cause a rare, but very serious reaction that excessively activates the body’s infection-fighting immune system”, leading to rashes or blisters, that could very quickly turn into an emergency situation and even cause death, if undiagnosed or untreated in time.

Can CBD Address These Concerns?

Are you struggling with the side effects of Lamictal and looking for a safer option, or are you keen on ridding yourself of your medical condition through a natural remedy?

Either way, you’re right to be apprehensive about your AED medications. Such adverse effects of medications often complicate life and reduce its quality. A lot of people look for safer options, as should you.

Quite a few anecdotal and scientific evidence have emerged that reflect well on natural extracts, like Cannabidiol (CBD), as safer, yet effective alternatives to conventional treatments.

CBD has been proven to alleviate the underlying causes of mood disorders, epilepsy, and other neuropsychiatric disorders.

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Can Cannabidiol Be An Effective Remedy?

CBD has emerged as a potent remedy to treat many common health issues, without experiencing the typical mind-altering effects of some cannabis compounds or prescription drugs. Interestingly, some of the most well-researched uses of CBD relates to potential therapy of neuropsychiatric and neurological disorders.

CBD has been found to be effective in helping manage pain, alleviating depression, reducing anxiety, bipolar disorder, and other neuropsychiatric disorders.

Let’s discuss what the researchers have found so far…

  • A 2015 clinical trial, published online in The Lancet, Neurology, verified the efficacy of CBD on patients, with treatment-resistant epilepsy, who had previously been on regular doses of AEDs. The studies indicated that the patients, who received oral CBD between 5mg – 50mg/kg/day, showed a reduction in the frequency of seizures. The tests also showed CBD was adequately safe, even on children.
  • Another 2017 randomized controlled trial, published in The New England Journal of Medicine, revealed that CBD oils were effective in reducing convulsive-seizures among children with a rare epileptic disorder, called Dravet Syndrome. However, it also indicated “higher rates of adverse events”.
  • Another study, published in the New England Journal of Medicine in 2018, found better results when CBD (10 – 20 mg/kg/day) was combined with regular AEDs to treat seizures in 225 Lennox-Gastaut syndrome patients. This test too showed some cases of liver damage due to CBD use.

CBD has also been proven to have some very positive effects on our moods, particularly in reducing depression and anxiety, like those associated with BPAD and BPD.

  • According to a 2018 study, published in the “Progress in Neuro-Psychopharmacology & Biological Psychiatry” indicated that small doses of CBD, coupled with equal doses of serotonergic agents, exhibits “antidepressant-like effects”, indicating that CBD may also be an effective agent of depression therapy.
  • According to a 2005 review, published in the Journal of Pharmacology, CBD, combined with low doses of THC, could be “therapeutic in bipolar patients with psychotic symptoms, and (its) anticonvulsant and protective effects may have a mood-stabilizing action similar to other anticonvulsants of proven value in BAD”.
  • However, a 2010 case report, published in the same journal (Journal of Pharmacology), indicated that “CBD may not be effective for the manic episode of BAD”.

Apart from these findings, some studies also point to CBD’s neuroprotective properties, while others indicate that this cannabinoid supports neurogenesis and nerve cell regeneration, besides activating several neural pathways that lead to lowering of depression and anxiety, as well as reversing damage caused by psychotic disorders.

CBD has numerous properties that seem to replicate the functions of many pharmaceutical medications. However, in complex disorders, like epilepsy and BPAD, any one drug or substance often proves ineffective.

So, patients often consider taking CBD along with AEDs, NDRIs, or SSRIs. Now the question arises: Can you use CBD while you are on Lamictal?

CBD-Lamictal Interaction: Can the two be mixed?

CBD tends to interact with most pharmaceutical drugs, especially the ones that come with the grapefruit warning.

CBD evidently inhibits the functions of certain Cytochrome P450 (CYPs) isozymes, a family of liver enzymes responsible for drug metabolism, thus hindering the breakdown of those drugs.

This leads to the drug staying in the bloodstream for an extended period, causing potential harm to the body, including a possible drug overdose and other medical complications. Is Lamictal one such drug?

So, Does CBD Interact With Lamictal?

Some studies indicate that there doesn’t seem to be any obvious signs of drug interaction when you use Lamotrigine with CBD.

However, is that the whole truth?

While it’s always best to consult your doctor about possible drug interactions, here are a few research papers and trial data that may interest you:

  • According to a Full‐Length Original Research, published in the Epilepsia – The Official Journal of the International League Against Epilepsy on August 6, 2017, “there were no significant changes in drug levels with CBD dose titration in the other AEDs analyzed”, including lamotrigine.

An interesting finding sheds more light on the effects of CBD on patients with treatment-resistant epilepsy (TRE).

  • A 2019 clinical trial, published in the Epilepsy & Behavior, not only exhibited no drug-drug interaction, it even displayed CBD’s abilities to lower seizure frequency and severity in patients with TRE, irrespective of AEDs. The trial proved that while AEDs were unable to make much difference, with or without cannabidiol, CBD use alone showed significant improvement in the patients.

Nevertheless, lamotrigine, among other newer AEDs seems to stimulate the metabolism of hormonal contraceptive pills, involving CYP3A4, which is one of the enzymes that CBD inhibits.

Besides, some studies on CBD also show that it may inhibit an enzyme, known as UGT2B7 (UDP-Glucuronosyltransferase-2B7), which is necessary for the metabolization of lamotrigine.

This, however, suggests a possible CBD-Lamictal interaction, leading to an increase in the concentrations of Lamictal in the bloodstream, thereby increasing the risk of further aggravation of Lamictal-related side effects.

Besides, the only FDA-approved CBD drug, Epidiolex, in its “prescribing information”, urges users to avoid lamotrigine, as “in vitro data predict drug-drug interactions with…UGT2B7”.

Before We Go…A Word Of Advice

Some people use CBD oils with prescription drugs, like lamotrigine, to alleviate the side-effects caused by such drugs, while others are more inclined towards replacing lamotrigine with CBD oil. In all likeliness, CBD does seem to be a helpful remedy to relieve the symptoms without causing too many side effects like most drugs.

Notwithstanding these benefits, CBD is still a reasonably new prospect in the field of medicine.

While there isn’t much evidence of severe drug reactions after consuming CBD oils with Lamictal other than some very mild side-effects, complaints of side-effects by patients, who regularly take Lamictal, are numerous as they are often.

In contrast, scientific research and anecdotal evidence seem to portray CBD as a potentially safe alternative.

Nevertheless, both epilepsy and bipolar disorders, two critical conditions that Lamictal is meant to treat, need proper medical care, which CBD may not be capable of providing given the inadequate regulation of CBD products and lack of sufficient scientific knowledge.

As of now, Epidiolex is the only FDA-approved CBD medication to be allowed for the treatment of two rare forms of epileptic disorders. It has also been approved to treat tuberous sclerosis complex patients.

Whether CBD, in general, can replace Lamictal or be administered along with it is still debatable.

So, our word of advice to our readers would be:

  1. Do your research to better understand all the pros and cons of CBD use for epilepsy and/or bipolar affective disorder.
  2. Consult your doctor before you self-administer CBD oil for either disorder.

Ivan writes about Cannabis at The Cannabis Radar. He has a degree in Nutrition Sciences from University of Oklahoma Health Sciences Centre. He likes to spend his spare time reading to his daughter or spending time with his wife.

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