The FDA has approved Lamictal for use as adjunctive therapy for partial seizures in children as young as 2 years. It is also approved as adjunctive therapy for generalized seizures in children with Lennox-Gastaut syndrome.

A main concern with Lamictal and its use for children is the interaction with valproate, because of the increased risk of severe rash. Lamictal should always be introduced gradually to prevent toxicity and the development of a rash. Other than rash, the most common side effects include dizziness, sleepiness, double vision, and sometimes upset stomach.

Dosage for Lamictal depends on the age of the child and whether the child is also taking valproate. For children aged 2 to 12 years who are also taking valproate, the starting dose is 0.15 mg/kg per day in one or two divided doses, and the usual maintenance dose is 1 to 5 mg/kg per day. Without valproate, children aged 2 to 12 years start at 0.6 mg/kg per day and the usual maintenance dose is 5 to 15 mg/kg per day.

For children over 12 years of age who are taking valproate, the starting dose is 25 mg every other day and the usual maintenance dose is 100 to 400 mg per day (in one or two divided doses). Children over 12 who don't take valproate usually start at 50 mg per day and work up to 300 to 500 mg per day.