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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by michael on November 13, 2001, at 23:13:27
Hello,
Three questions:
--Just wondering if anyone knows the liklihood of developing the rash/dangerous side effets, after stabilizing at a particular dose?
I titrated somewhat aggressively, but cautiously, and am currently at 150mg/day (75mg twice a day). This was my second day at 150mg. Haven't had any side effects to speak of to this point. Think I'm getting some benefit at this level, and plan to stay at this dosage for at least a week or two, and see how it goes. (fwiw, also taking 400mg wellbutrin sr)
Also, wondering:
--what dosage people have found to be an effective/theraputic/maintenance dose?
--are those of you who are NOT taking this specifically for Bipolar (i.e.: are using it primarily for antidepressant effects), typically using it to augment another AD, or trying it as monotherapy?
Thanks for any info/feedback/insights/personal experiences.
michael
Posted by JohnX2 on November 13, 2001, at 23:43:49
In reply to lamictal titration -- liklihood of side effects..., posted by michael on November 13, 2001, at 23:13:27
> Hello,
>
> Three questions:
>
> --Just wondering if anyone knows the liklihood of developing the rash/dangerous side effets, after stabilizing at a particular dose?
>
> I titrated somewhat aggressively, but cautiously, and am currently at 150mg/day (75mg twice a day). This was my second day at 150mg. Haven't had any side effects to speak of to this point. Think I'm getting some benefit at this level, and plan to stay at this dosage for at least a week or two, and see how it goes. (fwiw, also taking 400mg wellbutrin sr)
>If you went too fast to 150, you may get a bit of itchy skin or
blotchy red sun-burn looking skin or dermatitis. My experience
on lamictal dosing is that this occurs usually about 2-4 days after
bumping to the "critical dose". It usually goes away if I lower
the dose slightly and sit it out. I raised the dose unusually rapidly on my 2nd
shot and took precautions using anti-dandruff/psoriasis shampoo
on my head and rubbed it on my body. Also took zinc and selenium
supplements. Maybe it was bunk science, but I only had 1 rash scare
and it went away after 1 day.
> Also, wondering:
>
> --what dosage people have found to be an effective/theraputic/maintenance dose?100-300mg is typical. I use 150 mg.
>
> --are those of you who are NOT taking this specifically for Bipolar (i.e.: are using it primarily for antidepressant effects), typically using it to augment another AD, or trying it as monotherapy?Its my primary AD for bipolar. Only thing I found
that works with no side effects. On it for almost 1 year
with 0 relapses into major depression! This was after ~2 yrs
of cycling into/out of major depression while doing other
meds or not taking meds.regards & good luck,
john>
> Thanks for any info/feedback/insights/personal experiences.
>
> michael
Posted by Roo on November 14, 2001, at 9:15:41
In reply to Re: lamictal titration -- liklihood of side effects... » michael, posted by JohnX2 on November 13, 2001, at 23:43:49
Hi Michael--
I am using it some for cycling depression--as a
mood stablilizer, but mainly for it's antidepressant
effects. I also take prozac, 20 mgs. I plan to
try and taper completely off the prozac and just
use lamictal as my primary antidepressant. It seems
to be a very strong, effective med for me. I felt
it's AD qualities at 25 mg's, and even better at
now 50 mg's. I am not sure if I will be able to drop
the prozac without relapsing, but I am REALLY crossing
my fingers b/c lord knows, I am tired of the SSRI
side effects. I also take 1200 mg's neurotin which
I'd like to eventually drop or lower as well. I
have titrated extremely slowly. 12.5 mg's a week, and
if I get a skin reaction, I don't go up, I stay at
that dose for a longer time until the skin reaction
goes away...the biggest skin reaction (which wasn't
really THAT big) was when I bumped from 50 to 62.5..
I got a blister about the size of a quarter. I went
back down to 50 and have stayed there for 2 weeks,
after this week, I'm going to try to bump it again.
This is probably too much information, but I think
with these type of drugs that you have to titrate
slowly, you just have to listen to what you're body
is telling you.I have liked lamictal a lot. Good antidepressant!
Posted by sar on November 14, 2001, at 10:21:23
In reply to Re: lamictal titration -- liklihood of side effects..., posted by Roo on November 14, 2001, at 9:15:41
Roo,
that wasn't too much info for me--you are on exactly the same meds as me! i started lamictal nearly 2 weeks ago (at 25 mgs) and eagerly await results...
sar
Posted by Roo on November 14, 2001, at 12:22:56
In reply to Re: lamictal titration -- liklihood of side effects..., posted by Roo on November 14, 2001, at 9:15:41
Hey Sar--I'm am one of your psycho-social babble
fans. Always love your posts. I hope this drug
combo is a good one for you. Keep us updated on
how the lamictal is going for you. Do you feel
any benefit or side effects so far?
Posted by jazzdog on November 14, 2001, at 13:53:05
In reply to Re: lamictal titration --Sar, posted by Roo on November 14, 2001, at 12:22:56
Hi everyone. I've also just started lamictal, and am only at 12.5 mg. My skin has immediately started to itch, in an overall dry-skin kind of way. I have very sensitive skin at the best of times, and am vulnerable to all kinds of allergic and stress reactions. From what I've read, lamictal seems to increase skin sensitivity to sunlight, dryness, and other allergens. So I'm wonder if an antihistamine like reactine might be useful as I titrate up. As well as sunscreen, lots of bathoil, moisturizing, hypoallergenic soap and skin products, and avoiding wool, seafood, and other allergens. I already take zinc and selenium. And a slow 12.5 mg titration.
Any suggestions, comments? I really need this drug to work - it's the only thing that has been shown effective in the treatment of chronic derealization.
- Jane
Posted by sar on November 15, 2001, at 6:13:51
In reply to Re: lamictal titration --Sar, posted by Roo on November 14, 2001, at 12:22:56
> Hey Sar--I'm am one of your psycho-social babble
> fans. Always love your posts. I hope this drug
> combo is a good one for you. Keep us updated on
> how the lamictal is going for you. Do you feel
> any benefit or side effects so far?hey sweetie,
thanks for the compliment! the combo is good in the sense that neurontin does nothing for me with the exception of producing highly amusing, vivid dreams...you'll have to keep me updated on your lamictal titration, as i'm about to ramp up in a couple of days! i look forward to it....i love drugs... :) haven't felt any differemt, tho (25 mgs)
love,
sar
Posted by Karen Curtis on November 15, 2001, at 16:18:51
In reply to lamictal titration -- liklihood of side effects..., posted by michael on November 13, 2001, at 23:13:27
> Hello,
>
> Three questions:
>
> --Just wondering if anyone knows the liklihood of developing the rash/dangerous side effets, after stabilizing at a particular dose?
>
> I titrated somewhat aggressively, but cautiously, and am currently at 150mg/day (75mg twice a day). This was my second day at 150mg. Haven't had any side effects to speak of to this point. Think I'm getting some benefit at this level, and plan to stay at this dosage for at least a week or two, and see how it goes. (fwiw, also taking 400mg wellbutrin sr)
>
> Also, wondering:
>
> --what dosage people have found to be an effective/theraputic/maintenance dose?
>
> --are those of you who are NOT taking this specifically for Bipolar (i.e.: are using it primarily for antidepressant effects), typically using it to augment another AD, or trying it as monotherapy?
>
> Thanks for any info/feedback/insights/personal experiences.
>
> michaelmy son was on lamictal and depakote, and we titrated the lamictal so very slowly, and my son STILL got thrush on his tongue, and mouth sores all over, hasn't been able to eat for a week, we ended up in the ER. The pdoc said it was the start of SJ syndrome! Scary, but I bet if he was not on the depakote, he would not have had the problem. Karen Curtis
Posted by JohnX2 on November 16, 2001, at 14:36:58
In reply to Re: lamictal titration -side effects..son had them, posted by Karen Curtis on November 15, 2001, at 16:18:51
was your pdoc aware of the interaction
between depakote and lamictal? (depakote
increases lamictal in the body). Do you
think this was the primary culprit in the
adverse reaction?-john
> > Hello,
> >
> > Three questions:
> >
> > --Just wondering if anyone knows the liklihood of developing the rash/dangerous side effets, after stabilizing at a particular dose?
> >
> > I titrated somewhat aggressively, but cautiously, and am currently at 150mg/day (75mg twice a day). This was my second day at 150mg. Haven't had any side effects to speak of to this point. Think I'm getting some benefit at this level, and plan to stay at this dosage for at least a week or two, and see how it goes. (fwiw, also taking 400mg wellbutrin sr)
> >
> > Also, wondering:
> >
> > --what dosage people have found to be an effective/theraputic/maintenance dose?
> >
> > --are those of you who are NOT taking this specifically for Bipolar (i.e.: are using it primarily for antidepressant effects), typically using it to augment another AD, or trying it as monotherapy?
> >
> > Thanks for any info/feedback/insights/personal experiences.
> >
> > michael
>
> my son was on lamictal and depakote, and we titrated the lamictal so very slowly, and my son STILL got thrush on his tongue, and mouth sores all over, hasn't been able to eat for a week, we ended up in the ER. The pdoc said it was the start of SJ syndrome! Scary, but I bet if he was not on the depakote, he would not have had the problem. Karen Curtis
Posted by Karen Curtis on November 17, 2001, at 13:54:07
In reply to Re: lamictal titration -side effects..son had them » Karen Curtis, posted by JohnX2 on November 16, 2001, at 14:36:58
Yes, John, our pdoc was aware of it (he is excellent), and prescribed it at 12.5 for 2 weeks, hen 25mg for 2 weeks, then 50 for two weeks, and when we got up to 62.5 is when my son got sick. However, he had a little infection around his ring finger tip, and I am now convinced it is also from the lamictal Never again will we try this med! My son is still sick- he started with a fever, then got mouth sores (painful canker sores) all in his mouth, and thrush on his tongue. He still cannot eat much at all, too painfull. So now he is still on lithium and depakote too. We wanted to replace the lithium with the lamictal. (Hey, keep it in the L's). Well, we have to stick with the lithium for now- it just wasn't doing as much as we hoped to make the side effects worth it, (so now we give it all at night) but with the addition of the seroquel along with my sons geodon, he has improved. So maybe this combo will work for awhile. Karen Curtis
> was your pdoc aware of the interaction
> between depakote and lamictal? (depakote
> increases lamictal in the body). Do you
> think this was the primary culprit in the
> adverse reaction?
>
> -john
>
>
>
> > > Hello,
> > >
> > > Three questions:
> > >
> > > --Just wondering if anyone knows the liklihood of developing the rash/dangerous side effets, after stabilizing at a particular dose?
> > >
> > > I titrated somewhat aggressively, but cautiously, and am currently at 150mg/day (75mg twice a day). This was my second day at 150mg. Haven't had any side effects to speak of to this point. Think I'm getting some benefit at this level, and plan to stay at this dosage for at least a week or two, and see how it goes. (fwiw, also taking 400mg wellbutrin sr)
> > >
> > > Also, wondering:
> > >
> > > --what dosage people have found to be an effective/theraputic/maintenance dose?
> > >
> > > --are those of you who are NOT taking this specifically for Bipolar (i.e.: are using it primarily for antidepressant effects), typically using it to augment another AD, or trying it as monotherapy?
> > >
> > > Thanks for any info/feedback/insights/personal experiences.
> > >
> > > michael
> >
> > my son was on lamictal and depakote, and we titrated the lamictal so very slowly, and my son STILL got thrush on his tongue, and mouth sores all over, hasn't been able to eat for a week, we ended up in the ER. The pdoc said it was the start of SJ syndrome! Scary, but I bet if he was not on the depakote, he would not have had the problem. Karen Curtis
Posted by PaulB on November 18, 2001, at 8:27:54
In reply to lamictal titration -- liklihood of side effects..., posted by michael on November 13, 2001, at 23:13:27
> Hello,
>
> Three questions:
>
>Just wondering if anyone knows the liklihood of developing the rash/dangerous side effets, after stabilizing at a particular dose?>When I was on Lamictal the rash was a very serious consideration but properly adjusted tiltration reduces the risk of the Lamictal rash occuring to a great extent. My pdoc started me out at 12.5mg a day for one week and adjusted it by 12.5mg each week rather than starting at 25mg and then 2 weeks later increasing to 50mg and then 75mg 2 weeks later. I found 100mg to be an effective dose but I do know that higher doses are often needed especially to experience the Lamictal 'antidepressant' effect. I think the chance of developing a rash after stabilising on a particular dose is minimal.
>Also, wondering:
--are those of you who are NOT taking this specifically for Bipolar (i.e.: are using it primarily for antidepressant effects), typically using it to augment another AD, or trying it as monotherapy?Lamictal was used to augment my antidepressant Paroxetine in an attempt to stabilise my mood as I was experiencing manic episodes and mood swings. Lamictal was very helpful.
PaulB
Posted by JohnX2 on November 21, 2001, at 1:09:15
In reply to Re: lamictal titr-side effects..son had them; John, posted by Karen Curtis on November 17, 2001, at 13:54:07
Karen,Sorry things turned out so horribly.
I wish you the best of luck in the future.-john
> Yes, John, our pdoc was aware of it (he is excellent), and prescribed it at 12.5 for 2 weeks, hen 25mg for 2 weeks, then 50 for two weeks, and when we got up to 62.5 is when my son got sick. However, he had a little infection around his ring finger tip, and I am now convinced it is also from the lamictal Never again will we try this med! My son is still sick- he started with a fever, then got mouth sores (painful canker sores) all in his mouth, and thrush on his tongue. He still cannot eat much at all, too painfull. So now he is still on lithium and depakote too. We wanted to replace the lithium with the lamictal. (Hey, keep it in the L's). Well, we have to stick with the lithium for now- it just wasn't doing as much as we hoped to make the side effects worth it, (so now we give it all at night) but with the addition of the seroquel along with my sons geodon, he has improved. So maybe this combo will work for awhile. Karen Curtis
>
>
> > was your pdoc aware of the interaction
> > between depakote and lamictal? (depakote
> > increases lamictal in the body). Do you
> > think this was the primary culprit in the
> > adverse reaction?
> >
> > -john
> >
> >
> >
> > > > Hello,
> > > >
> > > > Three questions:
> > > >
> > > > --Just wondering if anyone knows the liklihood of developing the rash/dangerous side effets, after stabilizing at a particular dose?
> > > >
> > > > I titrated somewhat aggressively, but cautiously, and am currently at 150mg/day (75mg twice a day). This was my second day at 150mg. Haven't had any side effects to speak of to this point. Think I'm getting some benefit at this level, and plan to stay at this dosage for at least a week or two, and see how it goes. (fwiw, also taking 400mg wellbutrin sr)
> > > >
> > > > Also, wondering:
> > > >
> > > > --what dosage people have found to be an effective/theraputic/maintenance dose?
> > > >
> > > > --are those of you who are NOT taking this specifically for Bipolar (i.e.: are using it primarily for antidepressant effects), typically using it to augment another AD, or trying it as monotherapy?
> > > >
> > > > Thanks for any info/feedback/insights/personal experiences.
> > > >
> > > > michael
> > >
> > > my son was on lamictal and depakote, and we titrated the lamictal so very slowly, and my son STILL got thrush on his tongue, and mouth sores all over, hasn't been able to eat for a week, we ended up in the ER. The pdoc said it was the start of SJ syndrome! Scary, but I bet if he was not on the depakote, he would not have had the problem. Karen Curtis
Posted by Karen Curtis on November 21, 2001, at 17:57:31
In reply to Re: lamictal titr-side effects..son had them; John » Karen Curtis, posted by JohnX2 on November 21, 2001, at 1:09:15
>
Oh thankyou John!! I took my son to see the pdoc today, and the psychiatrist was pleased that he could have a conversation with my son, he is 12. Since I have increased the seroquel, my son is doing well. He is taking 600mg of seroquel, along with 140 of geodon (and depakote). Seems to work for now. Karen Curtis
> Karen,
>
> Sorry things turned out so horribly.
> I wish you the best of luck in the future.
>
> -john
>
>
>
> > Yes, John, our pdoc was aware of it (he is excellent), and prescribed it at 12.5 for 2 weeks, hen 25mg for 2 weeks, then 50 for two weeks, and when we got up to 62.5 is when my son got sick. However, he had a little infection around his ring finger tip, and I am now convinced it is also from the lamictal Never again will we try this med! My son is still sick- he started with a fever, then got mouth sores (painful canker sores) all in his mouth, and thrush on his tongue. He still cannot eat much at all, too painfull. So now he is still on lithium and depakote too. We wanted to replace the lithium with the lamictal. (Hey, keep it in the L's). Well, we have to stick with the lithium for now- it just wasn't doing as much as we hoped to make the side effects worth it, (so now we give it all at night) but with the addition of the seroquel along with my sons geodon, he has improved. So maybe this combo will work for awhile. Karen Curtis
> >
> >
> > > was your pdoc aware of the interaction
> > > between depakote and lamictal? (depakote
> > > increases lamictal in the body). Do you
> > > think this was the primary culprit in the
> > > adverse reaction?
> > >
> > > -john
> > >
> > >
> > >
> > > > > Hello,
> > > > >
> > > > > Three questions:
> > > > >
> > > > > --Just wondering if anyone knows the liklihood of developing the rash/dangerous side effets, after stabilizing at a particular dose?
> > > > >
> > > > > I titrated somewhat aggressively, but cautiously, and am currently at 150mg/day (75mg twice a day). This was my second day at 150mg. Haven't had any side effects to speak of to this point. Think I'm getting some benefit at this level, and plan to stay at this dosage for at least a week or two, and see how it goes. (fwiw, also taking 400mg wellbutrin sr)
> > > > >
> > > > > Also, wondering:
> > > > >
> > > > > --what dosage people have found to be an effective/theraputic/maintenance dose?
> > > > >
> > > > > --are those of you who are NOT taking this specifically for Bipolar (i.e.: are using it primarily for antidepressant effects), typically using it to augment another AD, or trying it as monotherapy?
> > > > >
> > > > > Thanks for any info/feedback/insights/personal experiences.
> > > > >
> > > > > michael
> > > >
> > > > my son was on lamictal and depakote, and we titrated the lamictal so very slowly, and my son STILL got thrush on his tongue, and mouth sores all over, hasn't been able to eat for a week, we ended up in the ER. The pdoc said it was the start of SJ syndrome! Scary, but I bet if he was not on the depakote, he would not have had the problem. Karen Curtis
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