Can Lamotrigine Cause Eye Twitching? A Look at Ocular Side Effects

October 10, 2025 •

4 min read

Case reports show that while rare, lamotrigine can cause involuntary eye blinking and other movement disorders [1.2.1, 1.2.2]. So, can lamotrigine cause eye twitching? This article examines the evidence, mechanisms, and management of this and other ocular side effects.

Quick Summary

While uncommon, evidence confirms lamotrigine can lead to various eye movement issues, including twitching, blinking, and blepharospasm. Other visual side effects are more common.

Key Points

Rare but Possible: Although uncommon, lamotrigine can cause eye twitching (blepharospasm) and other involuntary eye movements [1.2.1, 1.2.2].
Common Vision Issues: Blurred vision and double vision are much more frequently reported side effects of lamotrigine [1.3.1].
Mechanism Theory: The twitching may result from lamotrigine's effect on neurotransmitters, leading to a secondary disruption of the dopamine system [1.2.1].
Consult a Doctor: Never stop taking lamotrigine abruptly if you experience side effects; consult your doctor for guidance, as sudden cessation can cause seizures [1.3.1].
Symptom Resolution: In reported cases, lamotrigine-induced eye movement disorders often disappeared after the medication was discontinued [1.2.1].
Overdose Sign: Uncontrollable eye movements can be a symptom of a lamotrigine overdose and require immediate medical attention [1.3.5].
Treatment Options: For persistent blepharospasm, botulinum toxin injections are a common and effective treatment [1.5.1, 1.5.6].

Understanding Lamotrigine

Lamotrigine, sold under brand names like Lamictal, is a broad-spectrum antiepileptic drug (AED) [1.2.1]. It is widely used to manage and prevent seizures in adults and children and as a maintenance treatment for bipolar I disorder to delay mood episodes like depression, hypomania, or mania [1.4.5, 1.6.3]. The medication works primarily by inhibiting voltage-sensitive sodium channels in the brain, which stabilizes neuronal membranes and reduces the release of excitatory neurotransmitters like glutamate [1.2.1, 1.6.5]. This action helps calm overactive nerves in the body, preventing the irregular electrical activity that leads to seizures and mood episodes [1.6.3, 1.6.4].

The Link Between Lamotrigine and Eye Twitching

While common side effects of lamotrigine include dizziness, headache, and skin rash, involuntary movement disorders affecting the eyes are considered extremely rare [1.2.1, 1.4.5]. However, several case reports and studies have documented instances of lamotrigine-induced eye movement disorders, such as:

Excessive involuntary eye blinking [1.2.1, 1.2.7]
Blepharospasm (forceful, involuntary closure of the eyelids) [1.2.2, 1.2.8]
Facial tics [1.2.4]
Opsoclonus (rapid, irregular, multi-directional eye movements) [1.2.2]
Nystagmus (continuous, uncontrolled back-and-forth eye movements) [1.3.1, 1.3.4]

In some reported cases, these symptoms, such as excessive eye blinking, began months after starting the medication and resolved completely within a month of discontinuing it, indicating a close association [1.2.1, 1.2.3]. The exact mechanism is not fully understood, but one theory suggests that by inhibiting excitatory neurotransmitters, lamotrigine may indirectly cause a secondary dysfunction in the brain's dopaminergic system, which plays a role in controlling movement [1.2.1, 1.2.7].

Other Ocular and Vision-Related Side Effects

Beyond involuntary movements, lamotrigine is more commonly associated with other vision-related side effects. Clinical trials have frequently reported issues like blurred vision and diplopia (double vision) [1.3.1, 1.3.4, 1.4.4].

Common Vision Side Effects (affecting 1% to over 10% of users):

Diplopia (double vision): Reported in up to 28% of users [1.3.1].
Blurred vision: Reported in up to 16% of users [1.3.1].
Amblyopia (lazy eye) [1.3.1]
Nystagmus [1.3.1]

Less Common to Rare Ocular Side Effects:

Dry eyes and photophobia (light sensitivity) [1.3.1]
Conjunctivitis (pink eye) [1.3.1]
Uveitis (eye inflammation) [1.3.1]
Transient vision loss, particularly with high doses [1.3.2]
Retinal phototoxicity, a rare condition where the retina is damaged by light exposure, has been reported in patients on lamotrigine undergoing certain eye procedures [1.3.8].

Symptoms like blurred vision, double vision, and uncontrollable eye movements can also be signs of a lamotrigine overdose [1.3.5, 1.4.2].

Comparison of Neurological Side Effects

Different medications used for epilepsy and bipolar disorder have varying side effect profiles. Understanding these differences can help patients and doctors make informed decisions.


Side Effect	Lamotrigine	Valproic Acid (Depakote)	Lithium
Eye Twitching/Tics	Rare, but reported [1.2.2, 1.2.4]	Tremor is a common side effect, which can affect eyelids [1.2.3]	Tremor is very common and can manifest as eyelid twitching.
Double/Blurred Vision	Common [1.3.1]	Less common, but can occur.	Can occur, often related to toxicity.
Weight Gain	Generally considered weight-neutral; weight changes can occur [1.4.4, 1.6.1]	Common and often significant.	Common.
Sedation	Can cause drowsiness [1.4.5]	Common.	Can cause drowsiness, especially at the start of treatment.
Risk of Rash	Boxed warning for serious, potentially life-threatening rash (Stevens-Johnson syndrome) [1.4.5, 1.7.5]	Less common than with lamotrigine.	Can cause or worsen acne and psoriasis.

Managing Lamotrigine-Induced Eye Twitching

If you experience eye twitching while taking lamotrigine, it is crucial to consult your doctor. Do not stop taking the medication suddenly, as this can cause seizures to return or worsen [1.3.1].

Management strategies depend on the severity of the symptom:

Observation and Dose Adjustment: For minor twitches, your doctor may monitor the situation or slightly adjust your dose. Many side effects improve as your body adjusts to the medication [1.3.4].
Discontinuation: In cases where the eye twitching is persistent or severe, such as blepharospasm, discontinuing lamotrigine often leads to the resolution of symptoms [1.2.1, 1.2.3]. Your doctor will guide you on how to taper off the medication safely and may suggest an alternative.
Symptomatic Treatment: If the twitching persists or is diagnosed as benign essential blepharospasm, treatments like botulinum toxin (Botox) injections can be highly effective [1.5.1, 1.5.2, 1.5.6]. These injections work by temporarily relaxing the muscles around the eyes, stopping the spasms for several months [1.5.1].
Lifestyle Adjustments: For minor, transient eye twitches, general wellness strategies might help, such as reducing caffeine intake, ensuring adequate sleep, managing stress, and using lubricating eye drops [1.5.5, 1.5.7].

Conclusion

While lamotrigine is an effective medication for epilepsy and bipolar disorder, it is associated with a range of ocular side effects. Can lamotrigine cause eye twitching? Yes, although it is a rare occurrence, case studies confirm a link between the drug and various involuntary eye movements, including twitching, blepharospasm, and facial tics [1.2.2, 1.2.4]. More common vision problems like blurred and double vision are also well-documented [1.3.1]. Any new or worsening vision changes or involuntary movements should be reported to a healthcare provider immediately to rule out serious issues and determine the best course of action. Never alter your dosage or stop taking lamotrigine without medical supervision [1.3.1].

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your medication.

National Institutes of Health: A Case of Lamotrigine-Induced Excessive Involuntary Eye Blinking

Frequently Asked Questions

While usually not dangerous in itself, it should be evaluated by a doctor. Involuntary eye movements can also be a sign of a medication overdose, which is a medical emergency [1.3.5]. It's important to distinguish between a minor tic and a more serious movement disorder.

In several case reports, involuntary eye blinking and blepharospasm resolved within a month after stopping lamotrigine [1.2.1, 1.2.3]. However, you must consult your doctor before stopping the medication.

The most common side effects include dizziness, headache, blurred or double vision, nausea, drowsiness, and skin rash [1.4.5, 1.7.3].

Permanent visual damage is rare but has been reported in cases of severe overdose [1.3.2]. A very rare condition called retinal phototoxicity has also been associated with lamotrigine during certain vitreoretinal procedures [1.3.8]. Routine visual side effects typically resolve.

Check with your doctor right away if you experience blurred vision, double vision, or any other change in your sight. Your doctor may recommend an eye examination by an ophthalmologist [1.3.1].

The primary approach is often to lower the dose or discontinue lamotrigine under a doctor's supervision. If the spasm persists, botulinum toxin (Botox) injections are the most common and effective treatment [1.5.1, 1.5.6].

While the link isn't definitively dose-dependent for eye twitching specifically, side effects like dizziness, ataxia, and vision problems are often related to the dose [1.4.4]. Ocular abnormalities are also noted in cases of lamotrigine toxicity (overdose) [1.3.6].