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Lamotrigine Blood Level Test

The Lamotrigine Blood Level Test is a test to assess the levels of lamotrigine in blood.

What are the other Names for this Test? (Equivalent Terms)

  • Lamictal Levels Blood Test

What is Lamotrigine Blood Level Test? (Background Information)

  • Lamotrigine is an anticonvulsant drug used to treat seizures. It is also used to treat bipolar disorder and other psychiatric conditions. The drug is also known under the brand name Lamictal
  • Seizures are episodes of abnormal and excessive brain cell activity; they may last several seconds to even 5 minutes. Often, the cause of a seizure is unknown. A seizure may occur as result of a nervous system disorder, called epilepsy. They may also occur following a brain surgery
  • During a seizure, an individual may convulse or display other uncontrolled physical behaviors. Such seizures are said to be convulsive and convulsive seizures are the most common seizures
  • Alternatively, non-convulsive seizures do not exhibit this uncontrolled physical behavior. Instead, an individual experiencing this seizure type may momentarily lapse out of consciousness, effectively “zoning out”
  • Brain cells communicate to each other and to other cells, through electrical signals. During a seizure, brain cells are rendered excessively conductive. The brain cells that are over-conductive transfer electrical signals too freely. This results in the derailment of their communications system, causing either convulsive or non-convulsive effects of seizures
  • The drug lamotrigine is thought to work by dampening the activities of brain cells. It reduces the sky-high conductivity of brain cells to more functional levels. This is also how lamotrigine treats bipolar disorder and other psychiatric conditions.
  • Like every other drug, lamotrigine must be kept within a certain range, in order to prevent certain unwanted effects. If levels are too high, it may result in toxicity. If the levels are too low, the drug may not successfully ward-off a seizure attack
  • The Lamotrigine Blood Level Test is a test to assess the levels of lamotrigine in blood. It is used when adjusting the initial dose, and to ensure that lamotrigine levels stay within an acceptable range

What are the Clinical Indications for performing the Lamotrigine Blood Level Test?

The clinical indications for performing the Lamotrigine Blood Level Test include monitoring lamotrigine therapy.

How is the Specimen Collected for Lamotrigine Blood Level Test?

Following is the specimen collection process for Lamotrigine Blood Level Test:

Sample required: Blood

Process of obtaining blood sample in adults:

  • A band is wrapped around the arm, 3-4 inches above the collection site (superficial vein that lies within the elbow pit)
  • The site is cleaned with 70% alcohol in an outward spiral, away from the zone of needle insertion
  • The needle cap is removed and is held in line with the vein, pulling the skin tight
  • With a small and quick thrust, the vein is penetrated using the needle
  • The required amount of blood sample is collected by pulling the plunger of the syringe out slowly
  • The wrap band is removed, gauze is placed on the collection site, and the needle is removed
  • The blood is immediately transferred into the blood container, which has the appropriate preservative/clot activator/anti-coagulant
  • The syringe and the needle are disposed into the appropriate “sharp container” for safe and hygienic disposal

Preparation required: No special preparation is needed prior to the test.

What is the Significance of the Lamotrigine Blood Level Test Result?

The significance of the Lamotrigine Blood Level Test is explained:

  • Excessive lamotrigine levels may indicate lamotrigine toxicity, which is marked by:
    • Respiratory depression
    • Stupor    
    • Coma
    • Blurred vision
  • Low lamotrigine levels may indicate that more lamotrigine is necessary to achieve a therapeutic dose

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario.

Additional and Relevant Useful Information:

  • Women are more likely than men to exhibit lamotrigine’s side effects that include vision defects and poor coordination. This is in contrast to other anticonvulsant drugs, which typically cause more pronounced side effects in men. This is thought to occur because of interactions between the lamotrigine drug and female sex hormones such as estrogen

Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider of the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

Please visit our Laboratory Procedures Center for more physician-approved health information:


References and Information Sources used for the Article:

Fischer, R. (2005). Epileptic seizures and epilepsy: Definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia, 46(4), 470-72

Keogh, K. (2010). Nursing Laboratory and Diagnostic Tests Demystified. New York City, NY: McGraw-Hill Medical.

Lab Tests Online (2014, May 14). Retrieved May 24, 2014 from http://labtestsonline.org/understanding/analytes/carbamazepine/

Martini, F., Nath, J. L., & Bartholomew, E. F. (2012). Fundamentals of anatomy & physiology (9th ed.). San Francisco: Benjamin Cummings.

Schnell, Z. B., Van, L. A., & Kranpitz, T. R. (2003). Davis's Comprehensive handbook of laboratory and diagnostic tests: With nursing implications. Philadelphia: F.A. Davis.

US National Library of Medicine. (n.d.). Lamictal. Retrieved from http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d7e3572d-56fe-4727-2bb4-013ccca22678#nlm34070-3