The People's Perspective on Medicine


Lamictal is an anticonvulsant drug used to treat epilepsy and bipolar disorder. 

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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My M.D. switched me from lithium to lamotrigine in 2003 for bipolar disorder: Lamotrigine gave me my life back–no longer zombie-like. While on the Teva chewable (25 mg, 2x day), life was absolutely perfect so long as I never forgot to take it as prescribed. Some years later, when the pharmacist substituted a non-chewable, non-Teva product, I gradually dipped into depression and eventually realized the cause. My doctor immediately called in a new prescription specifying chewable Teva only, and I was back on the right track. I shared this with my brother, and he had similar issues but had not identified the cause.

Current concern: My prescription was just refilled with Alembic chewable (white elliptical blackberry, imprint L 218). I will ease into it as suggested by J L Ferguson above, monitor my outlook and hope for the best. I will also try to confirm that my original Teva chewable 25 mg has been discontinued. From experience, problems are noticeable within about 10 days.

My daughters have had their seizures controlled by the teva brand. They have tried several other generics and other than Lamictal , Teva seems to be the only brand to keep them free of seizures. We have been told that no one makes teva anymore and are frantic!! Is this true?? I am very worried for them!

I think Teva still makes the 25mg tablets. My pharmacy just switched to Unichem and I just had a breakthrough seizure after being free from them for 4 years. I’m taking 250mg twice a day and once I switched manufacturers, two weeks later I had an unexpected seizure. I’m not someone who just has them, I’ve always had a reason for my past seizures, be it alcohol, lack of sleep, missing a dose, etc. I no longer drink alcohol, didn’t miss a dose, and get good sleep, so my only possible explanation is the manufacturer switch. We’re looking into a lawyer to see if there’s a class action out there.

My daughter was taking the Teva brand as well, and the pharmacy has not been able to get it for the last three months. Two of those months was one manufacturer, and this month yet another different one. It’s nerve wracking!

When I took Lamictal I had no problems when they switched to generic and used dr reddys and that did not work and I was able to find Teva at Walgreens. Kroger and Albertsons did not carry or would not carry Teva. Teva works really well for me. Today Husband picks up my prescription I look at brand and I said there is no way I am taking that. So I will have to find another pharmacy that will carry Teva.

I will warn my doctors office to warn other patients not to take this drug made from India. I worked for the pharmacy business for several years as a pharmacy technician so I knew right away this was not going to work and having read the comments I will have to use my stockpile until I can find this again. It’s all about money why they want to do this to people I have no idea they should be sued.

Teva went out of business June 12th i can no longer get lamotrigine teva brand so I’ve been forced to get torrent brand i do know it’s here in the u.s.

Teva brand is still in business. My mom takes the Teva brand Lamotrigine. We get it at Walgreens, which is super expensive! But they are the only place that carries the Teva brand of Lamotrigine. She can’t take anything else.

I have been on Lamotrigine since 2004. Originally was brand name as not generic at the time. When generic became available, I was given Teva brand which worked fine. At some point, Merck switched suppliers and I received a generic from an Indian company, possibly Zaydus.

Within just a few days,I felt like my mind was failing me, it was like Teflon and nothing would stick. I was recovering from a traumatic brain injury and thought I was backsliding and losing my mind. It was so awful.

Being a registered nurse served me well, as I came to figure out it was the change in generic companies. I had my doc prescribe Teva brand for me andI was back to my usual self. No further problems.

Many years later, as I just received a supply from a different generic company, I’m experiencing similar issues. This lamotrigine is from a company called Cadil. I will be talking with my doc tomorrow about this situation and getting Teva brand again. It’s so difficult to deal with these kinds of problems. Thankfully, I went a long time before running into problems again.

Its Sep. 24th and I’m a mess. I used teva lamotrigine for over 10 years and am now also pretty despondent that its no longer. No other generic over the years has worked for me. I’m told my cost with insurance for lamictal brand is $289. Per month. Can’t afford it. Just tried Viola and getting ready to try Zydus.

I’ve taken lamotrigine for over 8 years. Wonder drug. I’ve had round, diamond, and shield shape with no problems. Pharmacy switched to cipla brand (pinkish oblong) and I started having problems 2-3 weeks later. I started itching everywhere. To the point that I’d made myself bleed due to scratching in my sleep. It had an insidious onset, so it took us forever to figure out that it was the lamotrigine.

It took about 2 months, but my mood started to destabilize as well. Went to see my Psych NP who, thankfully didn’t just switch or add meds. He felt it pretty unlikely that I would spontaneously destabilize like that, unless there was a problem with the drug.

Went to a different pharmacy, got a different manufacturer (back to the round ones) and within 2-3 weeks, my mood improved and the itching went away!

My wife had been stable on Lamictal (brand name) for seizures, then switched to Teva when it became available. The mail order pharmacy then switched her to Dr. Reddy’s and she began having breakthrough seizures.

After researching, found this to be a common problem with that Indian manufacturer. I worked a deal with a local independent pharmacy to provide only Teva and she was stable for years. Then, the pharmacy changed ownership and she got Unichem brand, another Indian manufacturer. No seizures, but definite auras and “weirdness”. Back to Teva tomorrow.

ZYDUS brand Lamictal generic didn’t work. It was laughable really, found myself crying and having breakthrough seizures lol. 200 mg twice daily. Unichem and Taro work fine.

I agree that the generic by Zydus is not helpful. Looked for a pharmacy with either Teva
or torrent. Started the torrent a few days ago, but am having problems with sleep and mood.
I had thought that Torrent was an ok manufacturer, though I did notice that it’s the same big white pills as the Zydus. Has anyone else had this same experience?

Cadista lamotrigine has given me serious problems. It seemed OK in 2012-13, then I started having complex partial seizures on it in 2014-15. In early January 2016, I had a tonic-clonic seizure while driving and ran into a truck at about 50 mph (I won’t be driving again for a long time). Then I researched which manufacturer of lamotrigine people seemed to like most, and switched to Teva. So far I’m much better, and at my Walgreen’s pharmacy it costs only $10, so I plan to stick with it. (In 2002-2012 I took levetiracetam, which worked, but made me depressed and unhappy.)

What does LAMOTRIGINE 100MG TAB CAD mean?
Does TAB mean tablet?
Does CAD mean Cadillac or cadista?
Is the CAD made by zydus in India?

TAB does mean tablet.
CAD stands for the manufacturer, Jubilant Cadista Pharmaceuticals, Inc.
Jubilant Cadista Pharmaceuticals Inc.
Salisbury, MD 21801, USA

Just started on the Cadista brand Lamotrigine on Saturday and have been having seizure, auras, nausea, and extreme sleepiness. I was on Teva brand Lamotrigine, but I don’t have insurance, and Walgreen’s increased their prices. My discount drug company only pays $200.00 which,leaves $100.00 balance.I can’t afford it so I ordered this off of Health Warehouse. I will never do it again. As soon as I can get back on the Teva I’m doing it.

I found a web site called Goodrx which has printable coupons for meds including Walgreens and other local stores in the area. I found out only Walgreens carries the TEVA brand. I take 150 mg 3 times a day. The regular price at Walgreens in my area is $265.49/mo, but with a coupon, and a new prescription from my Dr, the cost came down to $57.09/mo.! The coupon price is good for one year. That’s a savings of $2,500 in one year alone!

It is comforting to know I am not crazy and that others experience these differences. The lamotrigine brand Teva seems to work for me. Zydus does not and Cobalt is terrible. I get jittery and anxious and have trouble sleeping. I have always been a sound sleeper so this has been very troubling.
I have found the same thing with generic Zoloft -sertraline. For me, Teva works, Greenstone is second best but it’s a big difference and Zydus and Cobalt do not work. You may have to explain this to your doctor or bring in some of these kinds of articles/ discussions. My doctor writes for the specific manufacturer now. The new mail order CVS/Caremark that I have to use has not been responsive or helpful. I have been getting the short term refills of Greenstone at a local pharmacy. I agree that we need to be contacting our representatives about the lax oversight on generics and the dangers to patients! FDA is kowtowed by the drug manufacturers so not likely to do much.

I have encountered difficulty when switching between the brand name Lamictal to generic lamotrigine and when switching from one manufacturer to another. When I switched to the pills made by Teva, I had strong muscle cramps and clenched jaw and nystagmus (jerky eye movements). I went back to brand name. I switched to lamotrigine made by Taro and had no side effects. But, my pharmacy switched suppliers to Zydus and I am having strong muscle cramps and teeth clenching. Switching between generics can also cause problems. People metabolize lamotrigine differently and this leads to the different outcomes. It’s probably best to split your dose so that you don’t suddenly jump from one source to another and you can gradually transition to the new pills.

Ive been on lamictal for almost 10 years. Started with the name brand… Switched to generic when it came out and I feel like it was almost making my symptoms worse than if I had not taken any meds at all (I take lamical as a mood stabilizer and for seizures) so thank god that there is LAMICAL ODT and that there is no generic equivalent so your insurance can’t sub anything.

The Teva ones are different colors according to the mg. The blue ones are 200mg. hope this helps.

My daughter had a massive seizure last night. That makes 2 in one month after being seizure free for 9 yrs. I discovered the health ins. co. is sending a different generic (large white pills, manuf. by Cadila (Zydus)) for lamitrogine starting 1 month ago. For 9 yrs. she was on the blue triangular one manuf. by Teva.
The first event after getting the white pills she was driving with her 6 mo. old baby in the car. Pulled into a gas station and was taken by ambulance to hosp. where the incompetent doctors didn’t even recognize she was in the aftermath of a seizure. Her memory was messed up and she was crying and worried about her children. So the doctor who never even saw her ‘baker acted’ her adding that to what she was already suffering. Does anyone know how we can get the blue pills? Please help us if you do. Marcia

For me, Lamictal was a lifesaver (severe anxiety/depression, often couldn’t sleep or eat for days). When generic became available I tried a mail-order discount option, and got Dr. Reddy’s. Did not work. I threw them away. Teva is fine, for me; after over three years, I’m still on 150 mg, with no problem sleeping or eating, and enjoying life about as much as the average person, or maybe more.. I don’t think I’ve gained weight from the medicine–gained a little here and there and lost it again. I think it varies with the person, just like with which medicine, and you have to keep trying until you find what works.

My local pharmacy has been special ordering the TEVA brand for me. I have had other pharmacies order it for a while then they quit and try to get me to take the other generics. I honestly felt better on the TEVA brand then I did on the name brand. I had pharmacies and especially the mail order change my medicine 3 times to different generic brands.

The first two times I had seizures the 3rd one I just felt terrible. I don’t know which brands they were but as long as I can get the pharmacy to order it for me I will stay on the TEVA brand. My doctor told me that a lot of people was switching to TARO but I’m scared to change.

My daughter age 42 has a brain injury and is bipolar with a lot of ataxia,
her doctor upped her from 200 mg of Lamictal to 300 mg and she could not walk, see and server ataxia in her whole body. She is now hospitalized and I noticed the Med change was the only addition change to her life style.
Have you heard of this before? any suggestions?

I have been taking Lamotrigine 100mg X 2 a day for several months with great results. However, after reading comments from above I want to make sure my pills are being filled correctly. Mine are by Teva but they are triangle light pink pills, and the comments above say they are blue pills if are by Teva and white by the india company. Please clear this matter with me.

I have taken Lamictal for over 3 yrs with great results for Bipolar II mood swings. I noticed the sudden depression before I realized that the brand had been replaced by a generic (Teva)–so there was no way that this was just my imagination, or due to my expectations that the generic wouldn’t be as effective. Again, I didn’t even know there had been a switch!
When my mood went into the pits I never associated it w/ any change in the lamotrogine. Then I heard an unrelated PP prog on NPR and I checked out this website. I looked up the various medications I was on and that was the first time I discovered there was a problem with the generic lamotrogine. Definitely a light bulb moment! My Dr was able to get me back on the brand (I have a higher co-pay but it’s still covered so I’m fortunate). There IS a difference in the generics–legally they can have a + or – % difference in the amount of the active ingredient–on top of that, the same ingredients could be processed differently so it would look as if the medication is the same in terms of ingredients but actually the end product is different.
Bottom line is these generics aren’t controlled for quality and aren’t regulated adequately so when anyone says that the generic is EXACTLY the same as the brand name either they’re ignorant of the facts or deliberately lying about it.

I started to take generic Lamotramigine made by Taro for a mood disorder and had great results from it. Medco refused to pay after the third prescription through a retail pharmacy and offered a 90 day supply for $39.00, I was thrilled. This was made by Zydus and have never heard of it before, I contacted a few local pharmacies and was told they don’t use this manufacturer often. I had no choice with a 90 day now and tried it.
Day 1 I took a 1/4 tablet, day 2, I took a 1/4 tablet and each day within one hour after taking it I felt a little sick and had stomach pain. On day 3 I took a 1/4 in the a.m. and a 1/4 in the p.m. which was recommended initially. On day 4 I couldn’t move or talk in the morning. My lips, tongue, eyes and throat were swollen and I was choking. Couldn’t roll over to call 911 and passed out until 11:30 a.m. got up, took shower and was able to function as usual still feeling bit sluggish.
I went back on Taro with an override fro Dr. and felt fine so I insisted for Medco to get paperwork going for BRAND ONLY. After doing that and doing research, I found that Brand had the same inactive ingredients as Zydus. No one can answer to me weather or not one of the fillers could have just been extremely high in this generic and that may have caused it.
My hands are tied because local pharmacies get in cheapest bulk month by month and won’t special order.

My wife has dealt with seizures and bipolar for 30 years and was reasonably controlled with the brand product of Lamictal. She too received the large white generic tablets from our mail order pharmacy manufactured by Cadila (Zydus) and has been having too many seizures and mood swings to count. She has now reached the point of being afraid to go out of the house and in public because of these problems.
I am very glad to find out others have also had this problem so I will be contacting her doctor tomorrow and having him rewrite the script for the brand product with no exceptions.

I am surprised to see that people are liking the Teva. Just 10 days on it and I was into a full-blown mixed state, something that I hadn’t done for 3 years on the brand name Lamictal. I had to be hospitalized for 2 days.
These generics are just not being regulated effectively.

Has anyone come across a Lamotragin generic from a company called Cipla? It’s also a larger white tablet and made in India, but not the one referred to in the earlier comments from Zydus Cadila.

Hi i recently heard on npr that some problems keep popping up with some generic brands of lamictal. I had been through a very bad depression and my meds had to be doubled. I had gone 15 years without a major episode and because of what I heard on the radio I checked my med history and discovered that shortly after my generic brand was changed to zydus cadista my mood started dipping and it was down hill from there.
I am now very glad to say my insurance has changed and I’m now on another reliable brand generic. When I’ve gone 6 months without a problem I will tell my doctor about this and maybe my he can lower the dose. He’s the man and I don’t do anything without his guidance. So we’ll see. I’m back on the track and feeling well, If my meds are change back to ZC I’ll fight to stop it. I’m not going down that road again. Those ceo’s don’t know what it’s like to claw their way out of the tar pit.

I too am having the same problem with zydus cadista, completely does not work like teva or the brand name lamictal.

I’ve been on Lamotrigine for over a year for bipolar with wonderful results, however, recently my mail order company sent me a new generic made by Zydus Cadila, (I had been taking Lamotrigine made by Teva out of Israel). Within a week I had digressed to the point I had to take a day off of work. I had heard that the FDA was concerned about the drugs coming out of India (where Zydus is out of), but since they have no jurisdiction there, they cannot stop the importation of the drug without legislation.
I am currently working with my doctor and insurance company to get me back onto the Teva made Lamotrigine. (By the way, my nurse knew of the problem with drugs made in India and was completely sympathetic.) This is a serious issue in which I am going to contact my representative to inform him of the speed in which legislation barring prescriptions from India needs to be done. The difference of the pill in looks is that Teva makes Lamotrigine now in a small blue round pill while Zydus’ Lamotrigine is a larger round white pill. Anyone who suddenly receives these large white pills, beware!

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