Lamictal & Arrhythmia
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Q:  Lamictal & Arrhythmia

I was prescribed Lamictal for a trial diagnosis of Bipolar 2 disorder (rapid cycling  - depression & severe anxiety).  Lamictal was a wonder drug for my mood.  For the first time in many years I felt calm and "normal."  However, as we arrived at a therapeutic dose (100 mg), I began having an irregular heart beat.  It persisted and I saw a cardiologist who diagnosed me with atrial fibrillation.  He and my psychiatrist do not think that Lamictal is associated with the rapid heart beat. I got off of Lamictal because I wasn't convinced that there was no correlation and indeed the heart beat returned to normal - for several weeks.  Then the arrythmia returned but was less severe.  My anxiety and mood swings also returned so I decided to get back on the Lamictal. However, as i increase the dose (I'm now at 50 mg) the arrythmia is getting more and more severe.  My heart beats very rapidly and I lose my breath and all energy - all of this despite the medication prescribed by my cardiologist (Verapamil).  Is there any know association between Lamictal and arrythmias?  Is it possible? Any suggestions would be greatly appreciated.  Thank you very much.


Dear Michael --
Haven't heard of this. So, searching
PUB MED with "lamotrigine arrhythmia", we find one article from Switzerland in which a research team studied the cardiologic effects of lamotrigine. They found none, basically, though this was a tiny study.

However, the connection seems fairly direct in your case given your on-off-on test results. I'm sorry to say I have nothing to recommend. I wonder if another cardiologist might offer some more aggressive means of controlling a'fib, if you wanted to explore ways to stay on lamotrigine? There are some "ablation" techniques which have very high success rates in spontaneous atrial fibrillation: a little scary, but perhaps worth looking into if the response to lamotrigine was that good (some people would consider the ablation treatment just to limit the effects of a'fib' alone).

Dr. Phelps

Published September, 2004


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