For bipolar disorder/mood swings, we don’t really know. We have some ideas, but nothing has really been proven about how lamotrigine works. https://journals.lww.com/psychopharmacology/abstract/2003/10000/potential_mechanisms_of_action_of_lamotrigine_in.11.aspx
Lamotrigine was originally developed as an anti-seizure medication that works by tamping down on excessive electrical signaling in the brain. It also inhibits the actions of glutamate, which is essentially your brain’s accelerator/gas pedal (as opposed to GABA which is the brain’s brake). It’s not currently known how much overlap there is between the anti-seizure mechanism and the mechanism that helps treat bipolar.
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