My doctor started me off at .25mg for a week, then bumped me up .25mg every week until I was at 100mg. No side effects. I was also on Effexor, which my doctor wanted to wean me off of. So he began reducing my Effexor at the same time he increased my Lamictal. No side effects. Now I'm at 300mg of Lamictal and it's the only thing that's holding me together...even though I'm still rapid cycling, and I have really bad days and really good days. I totally believe it kept me from going back in. I was a mess after almost a year of nothing but increasing Effexor and changing meds every 3 weeks.