Can You Drink on Lamictal?

We might know her as the charming Princess Leia in her trademark white jumpsuit and iconic “cinnamon buns” hairstyle, but Carrie Fisher had a dark side to her life that many didn’t know about until much later. As she got older, Fisher became more open about her struggles with bipolar disorder, describing it as a roller coaster of emotional states: “Mania starts off fun — not sleeping for days, keeping company with your brain, which has become a wonderful computer, showing 24 TV channels all about you. That goes horribly wrong after a while.”

Fisher also talked about the medications she took for her condition, and her ability to regain some control over her life. “Bipolar disorder can be a great teacher,” she reassured others. “It’s a challenge, but it can set you up to be able to do almost anything else in your life.”

If you’ve had similar experiences, you know that the right medication can make all the difference in dealing with bipolar disorder, and for many, lamotrigine (Lamictal) can be a lifesaver. But can you drink on Lamictal? What are the risks of mixing lamotrigine and alcohol? Let’s find out more.

What Is Lamictal?

Lamictal is a medication primarily used to treat epilepsy and bipolar disorder. It works by stabilizing electrical activity in the brain to prevent seizures and mood swings.

According to the National Alliance on Mental Illness, lamotrigine is a mood stabilizer used to treat bipolar disorder (also known as manic depression), as well as certain types of seizure disorders. 

Riding the Bipolar Roller Coaster

Characterized by extreme ups and downs, bipolar disorder can leave us feeling unbalanced and exhausted, unable to find our footing. Here’s an overview of what we might be dealing with.

On the depression side, we might experience some extreme lows:

• Sadness. We might experience classic symptoms of depression — sadness, a low mood, and crying spells.
• Feelings of guilt and hopelessness. We might feel guilty or worthless, lose hope, or feel as if we can’t cope with our situation.
• Anhedonia. Activities we used to enjoy might lose their spark, leaving us apathetic to things that used to bring us happiness.
• Changes in sleep and eating habits. We might find our sleep and eating habits changing (usually doing less of both).
• Exhaustion. Our energy reserves are likely to tank, and we might have trouble concentrating.
• Energy shifts. We might feel like we’re full of nervous energy, known as psychomotor agitation, or experience the opposite effect, known as psychomotor retardation. The latter makes us feel as if we’re moving in slow motion.
• Thoughts of self-harm. We might experience suicidal thoughts. This is a symptom we should never ignore. If you are experiencing thoughts of suicide, please seek medical attention. In the United States, you can reach your local crisis hotline by dialing 988. Click here for a list of mental crisis phone numbers by country. 

The other side of the coin — mania — can be just as exhausting in a different way. Here’s what we might experience:

• Irritability. We might feel on edge or easily irritated, with small things setting us off.
• Increased self-esteem. We might feel as if we’re “on top of the world” (sometimes for no reason).
• Decreased need for sleep. Unlike the depressive period, manic episodes might leave us with what seems like an endless energy supply.
• Increased need to talk. We might turn into a chatterbox, compelled to share every thought that enters our mind.
• Racing thoughts. Our thoughts might speed up, making it hard to keep up.
• Distraction. We might get easily distracted by anything that crosses our path (or enters our mind).
• Increased risk-taking. That “top of the world” feeling might make us prone to take unnecessary risks or engage in activities that could be dangerous.

Lamictal can help even out the extremes of depression and mania. That said, it’s considered to be an “off-label” treatment for the condition, meaning that it’s not officially approved by the Food and Drug Administration to be used for this purpose. This means that our healthcare provider should be actively involved in helping us decide if Lamictal is right for us or if a different treatment option would be more appropriate.

Can You Drink on Lamictal?

Now that we have an idea of what Lamictal is and what it’s used for, let’s explore why mixing lamotrigine and alcohol is not a good idea.

1. Mixing Alcohol and Lamictal Can Increase Lamictal Side Effects 

Common side effects of Lamictal don’t mix well with alcohol:

• Gastrointestinal effects. Lamictal can cause nausea and diarrhea, especially if we have a sensitive stomach. Alcohol can do a number on our digestive system as well, leading to both diarrhea and nausea. It’s also a stomach irritant that can cause acid reflux and even lead to gastritis over time.
• Insomnia and abnormal dreams. Insomnia is another common side effect, and despite what we might believe about alcohol’s sleep-inducing effects, it can actually deprive us of the most restful stages of slumber. The result? We might doze off quickly but wake up frequently in the middle of the night and end up feeling groggy in the morning.
• Rash. Lamictal can cause us to break out in a rash, and alcohol can contribute to facial redness, making the irritation a bit more noticeable. While for some the rash might be mild, for others it can be very serious, requiring medical attention. If that's you, seek medical help right away!"
• Headache. Headaches are another side effect of Lamictal, and booze can make things worse. We all know about hangover headaches, caused mainly by the dehydrating effects of alcohol. But that’s not the end of the story — alcohol can also trigger “cocktail headaches” due to fluctuations in blood pressure and vasodilation (the widening of blood vessels).
• Dizziness or drowsiness. This one’s the most important as far as side effects are concerned. Both Lamictal and alcohol can make us drowsy, so performing tasks that require our full attention can be tricky (or even dangerous). 
• Fatigue. Remember how we said alcohol interferes with sleep? Fatigue caused by Lamictal can make things even worse, leaving us too tired to face the day. Definitely not what we want when we’re struggling with challenging mental health symptoms! Plus, being fatigued can leave us more vulnerable to injuries or accidents associated with excessive drinking.

As we can see, the side effects of Lamictal and alcohol tend to increase if we mix the two. But that’s not the only reason to steer clear of the combo.

2. Alcohol and Seizures

Another reason why mixing Lamictal and alcohol could lead to trouble? Alcohol (as well as alcohol withdrawal) can be a seizure trigger. And if we’re taking Lamictal to prevent seizures, adding booze to the mix could be counterproductive.

3. Alcohol and Mental Health

Finally, alcohol’s negative effect on our mental health is another reason why the Lamictal-alcohol combo could land us in dangerous waters.

• Alcohol is a depressant. As a depressant, alcohol is particularly likely to make the lows lower if we’re struggling with bipolar disorder. For those taking Lamictal for mood stability, the benefits could be negated by frequent drinking, which can induce severe depressive states. 
• Alcohol can cause mood swings. You know how that funny story our friend is telling us can make us suddenly teary-eyed when we’re drinking? Alcohol is known to cause mood swings. And if we’re already dealing with unstable moods, this is not the effect we want. But the effect isn’t just to enhance the lows. Although (as we mentioned earlier) booze is more likely to dial up our depressive symptoms, it’s also known to trigger manic episodes. 
• Alcohol can make existing mental health issues worse. Science shows that alcohol is linked to mental health issues such as depression and bipolar disorder and can have an overall negative effect on them. So trying to control our symptoms with Lamictal while drinking will make the task that much harder. (For more information about the link between alcohol and bipolar depression symptoms, check out “Alcohol and Bipolar Disorder: What's the Connection?” and “Alcohol Misuse and Depression: What’s the Connection?”)
• We might be less likely to stick to instructions while drinking. Last but not least, booze isn’t conducive to helping us follow instructions of any kind (let alone read the fine print on medication bottles). We might miss our dose, causing our symptoms to return or making new ones crop up.

With all of the ways alcohol can interfere with our mental health, mixing Lamictal and booze is counterproductive, to say the least. If we weren’t convinced before, the situation should be pretty clear by now: drinking on Lamictal is not a good idea.

What Happens If You Drink on Lamictal?

You might be wondering, just how serious is mixing Lamictal and alcohol? Before you start Googling, “Can lamotrigine and alcohol kill you?” take a deep breath. The answer is — probably not.  

But you should still be careful. According to the NHS, “During the first few days of taking lamotrigine, it's best to stop drinking alcohol until you see how the medicine affects you.”

Tips To Stay Safe on Lamictal

And now, here are some tips to stay safe and take care of your mental health while taking Lamictal:

1. Avoid mixing lamotrigine with alcohol. To make sure your side effects don’t increase and to avoid making your symptoms worse, avoid the lamotrigine-alcohol combo. Instead of thinking of it as a restriction, think of it as an opportunity to discover the healthiest and happiest version of yourself.
2. Keep track of your symptoms. Stay on top of your symptoms and note any changes, especially when starting a new medication. Also keep track of any side effects, especially ones that interfere with your daily activities or ones you find troubling. You might find it more convenient to jot down notes on your phone to have them handy for your next doctor’s visit.
3. Talk to your doctor. Be honest with your doctor about your symptoms, reactions to medications, and alcohol use. Even if you do end up drinking, don’t hesitate to ask for advice — they’ve heard it all and are there to help. If you notice any changes in your mental health — especially if you’re feeling more depressed than usual or are finding it difficult to cut back on drinking as you proceed in your treatment — make sure to discuss those issues with your team. That’s what they’re there for!
4. Consider alternatives. As you explore life with less alcohol, try to actively seek out fun alternatives. Is it hiking on the weekend? Organizing trivia night with friends? Trying an online kickboxing class for a natural boost of endorphins and dopamine? There are plenty of booze-free activities out there to explore. They’ll provide a great alternative to alcohol while also boosting your overall mental health, providing additional relief from your symptoms.

And remember, Reframe is here to help you every step of the way! Check out our 24/7 Forum to connect with people just like you. Many of our users have experience dealing with mental health struggles as they explore their relationship with alcohol and can offer valuable support and advice. 

Shedding Light on Mental Health

In the end, taking charge of your mental health is a sign of strength. Congratulations on making an active effort! Remember, many people — including Carrie Fisher and others who have struggled with bipolar symptoms — have found a way out. Let’s continue to shed light on these challenges as we find solutions together.