What it's used for
- Bipolar depression prevention
- Epilepsy
Read about: Bipolar disorder
How it works: Blocks voltage-gated sodium channels and reduces glutamate release.
Common side effects
- Headache
- Dizziness
- Rash (rarely serious — Stevens–Johnson syndrome)
Tapering considerations
- Taper over at least 2 weeks to reduce seizure risk.
- If stopped for more than ~5 half-lives, restarting needs full re-titration.
For prescribers & facilitators
- Restarting at the old dose risks serious rash.
Sources
- 01Effects of the rate of discontinuing lithium maintenance treatment in bipolar disorders
Baldessarini et al., Journal of Clinical Psychiatry, 1996
- 02Bipolar disorder: assessment and management (CG185)
NICE Guideline, 2014
- 03The Maudsley Deprescribing Guidelines
Horowitz & Taylor, Wiley-Blackwell, 2024