Considering Lamictal for Anxiety? Read This

6 min.

What psychiatric providers have to say about whether or not you should use Lamictal for anxiety treatment.

By: Dr. Eli Muhrer, M.D.

May 7, 2024


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Anxiety disorders are common mental health concerns, affecting over 300 million people worldwide, data shows. No matter what type of anxiety disorder someone struggles with, their anxiety can cause extreme distress, resulting in difficulty functioning day-to-day and reduced quality of life. 

For many people with anxiety, medication is an important part of their treatment plan. Taking Lamictal for anxiety might be one path that people are curious about, but is it actually effective for treating anxiety disorders? Read on to learn from psychiatric providers about what Lamictal is, the conditions it helps, and other types of medications that you might take for anxiety. 

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Is Lamictal effective for treating anxiety?

In short, no. “There is very little evidence that lamotrigine is effective in treating anxiety as a primary treatment,” says Claire Streeter, a psychiatric nurse practitioner with Charlie Health, referring to the drug by its generic name. 

Lamotrigine belongs to a class of medications known as anticonvulsants, which means it’s technically a seizure medicine. The drug’s original intended use was for people with epilepsy, but it was later found to be effective as a mood stabilizer for treating bipolar disorder (also known as bipolar depression). More specifically, lamotrigine is used for the maintenance treatment of bipolar I disorder rather than bipolar II disorder. It’s available as an oral tablet, extended-release tablet (Lamictal XR), orally disintegrating tablet (Lamictal ODT), and chewable dispersible tablet.

Although lamotrigine is only FDA-approved for bipolar disorder I treatment in the mental health realm, prescribers may also use it as an add-on medication for people with depression who aren’t getting enough relief from their first-line antidepressant, Streeter adds. For this reason, lamotrigine is not typically used as an anxiety-specific treatment, especially when there’s strong evidence for other psychiatric medications to treat anxiety effectively, she says. 

Since Lamictal’s indication in psychiatry is as a mood stabilizer, it makes sense that it doesn’t necessarily improve anxiety symptoms. So, if you struggle with anxiety, Lamictal is not your best bet, according to Streeter. Mood stabilizers are better suited for treating mood disorders like bipolar disorder or depression in cases where a prescriber determines it would be a beneficial add-on treatment. 

However, if you have an anxiety disorder and bipolar I disorder or major depressive disorder, then it’s possible for a mental health professional to prescribe you lamotrigine to manage the mood disorder and then another medication to specifically target your anxiety symptoms. 

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What are other current treatments for anxiety disorders?

There are many medication options for people with anxiety disorders. Whether you have generalized anxiety disorder, panic disorder, social anxiety disorder, or separation anxiety disorder, there are medications that have plenty of evidence supporting their effectiveness –– as opposed to using Lamictal for anxiety, which lacks sufficient evidence.

The most commonly used first-line medications for anxiety disorders are selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), says Rebecca Holland, a psychiatric nurse practitioner with Charlie Health. SSRIs and SNRIs both target chemicals in the brain that are related to anxiety, whereas lamotrigine does not. Other common non-first-line anxiety meds include:

  • BuSpar (generic name buspirone): an anti-anxiety medication typically used for treating generalized anxiety disorder alone or alongside an SSRI or SNRI
  • Benzodiazepines: fast-acting sedatives that can be helpful for people with panic disorder when used on a short-term and as-needed basis (like during a panic attack)
  • Beta-blockers: drugs originally intended for treating cardiovascular conditions used “off-label” to treat anxiety disorder “adrenaline symptoms” (heart racing, sweating, shaking, etc.) on a short-term, as-needed basis
  • Hydroxyzine: an antihistamine in the same family as Benadryl (diphenhydramine) that is FDA-approved for treating anxiety symptoms.
  • Other types of antidepressants may be used on a case-by-case basis.

Ultimately, your treatment plan will be unique to you. As you can see, there are many types of anxiety medications available. These meds can be used on their own or in combination with others. “Decisions about treatment options for anxiety should be based on the individual,” says Streeter. “We want to take into account the severity of symptoms, medication side effect concerns, and other variations in presentation and preference.”

Keep in mind that it takes time for psychiatric medications to work. Depending on what medication your mental healthcare provider prescribes you, it can take several weeks or a couple of months to notice a difference in your symptoms. 

Regardless of whether you’re prescribed lamotrigine or another medication, it’s important to be aware of any potential common side effects, rare side effects, and drug interactions. For example, in the case of lamotrigine, the side effect of a severe skin rash is a potentially life-threatening possibility that you should be aware of when starting the medication. Make sure to ask your healthcare provider what you should know when starting any new prescription. 

Therapy for anxiety 

On top of medication, therapy is a crucial aspect of anxiety disorder treatment. “Generally, research has shown therapy and medication combined as a treatment for anxiety is most effective,” Streeter says. 

That’s why having a care team of a therapist and a medical professional such as a psychiatrist or psychiatric nurse practitioner is so helpful. “Medications get your symptoms to this level of manageability where you can really connect with therapy, get the insight into your symptoms, and learn the skills that you can use every day,” echoes Holland. There are various types of therapy for anxiety disorders, including these commonly used modalities:

Cognitive behavioral therapy (CBT)

CBT is one of the first-line therapy types for many mental health conditions ranging from anxiety disorders to mood disorders such as depression or bipolar disorder. This therapy is based on how feelings, thoughts, and behaviors are interconnected. CBT can help you become aware of your anxious thought patterns and feelings, giving you the tools and power to reframe negative beliefs into healthier ones. You’ll also learn helpful coping skills and relaxation techniques. 

Acceptance and commitment therapy (ACT)

ACT integrates mindfulness and acceptance strategies. In ACT, you’re encouraged to acknowledge and accept your anxious thoughts and experiences without judgment or resistance. For some people, trying to push away anxiety symptoms can amplify them, so the acceptance part of ACT can be very helpful for those individuals. By fostering self-compassion and embracing discomfort associated with anxiety, you can gradually shift your focus towards living life in line with your values.

Exposure therapy

Exposure therapy is a form of CBT. It’s typically used for people with specific phobias, anxiety related to trauma, social anxiety disorder, or panic disorder. When you avoid something that you fear, you inadvertently give it more power and reinforce the anxiety. In exposure therapy, you’ll safely and gradually expose yourself to your triggers. Ultimately, this helps you become more desensitized to them, which decreases your anxiety response.

Dialectical behavior therapy (DBT)

DBT is a skills-based therapy that helps you learn to regulate difficult emotions and tolerate distress. There’s a mix of individual therapy, supported groups, and skills training. DBT skills include mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness –– which can be helpful for coping with anxiety symptoms. 

Medication management at Charlie Health

If you or a loved one are struggling with anxiety, Charlie Health is here to help. Charlie Health’s virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for teens, young adults, and families dealing with serious mental health conditions, including anxiety disorders, depression, bipolar disorder I, bipolar disorder II, and more. 

Our care team incorporates evidence-based therapies into individual counseling, family therapy, and group sessions. We also offer medication management to clients as needed. With a combination of medication and therapy, feeling better is within reach. Fill out the form below or give us a call to start healing today.

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