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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by lymom3 on August 6, 2006, at 17:07:38
Pdoc back from vacation and actually called me today (on a Sunday!!...that's one of the reasons that I really appreciate that man). He wants me to stay at 50mg of Lamictal. I felt like there was some benefits starting there. It was when I went to the 100mg that I started having problems. Back down to 50 now and I'm ok again. He wants to add Topamax now. I have no knowledge of that medication. Anyone out there ever been on a similar combo?
Thanks,
Lisa
Posted by SLS on August 6, 2006, at 19:03:20
In reply to Lamictal and Topamax, posted by lymom3 on August 6, 2006, at 17:07:38
Hi Lisa.
> Pdoc back from vacation and actually called me today (on a Sunday!!...that's one of the reasons that I really appreciate that man). He wants me to stay at 50mg of Lamictal. I felt like there was some benefits starting there. It was when I went to the 100mg that I started having problems. Back down to 50 now and I'm ok again. He wants to add Topamax now. I have no knowledge of that medication. Anyone out there ever been on a similar combo?
I am currently taking Lamictal 150mg + Topamax 100mg in addition to a few other things.
What problems emerged when you increased the Lamictal to 100mg?
What would you like to know about these drugs?
- Scott
Posted by lymom3 on August 6, 2006, at 21:06:50
In reply to Re: Lamictal and Topamax, posted by SLS on August 6, 2006, at 19:03:20
When I hit 100mg of the Lamictal I started having unexplained bruising and purple spots. Also started having chest pains. I did get checked out by my primary care doc to make sure she couldn't find anything wrong. Once I backed down to 50mg again I haven't had any problems. Pdoc wants to leave me on that because I did have the beginnings of good effects and add Topamax to it. I don't know anything about Topamax and am not sure how it should or will augment what help I am getting now. I also take 60mg of Ritalin LA for ADHD and 80mg of Inderal LA for migraines. Might stop the Inderal soon as my migraines went away when I stopped taking anti depressants...at least until I went up to 100mg of Lamictal. They started up again but have gone away now that I'm back on 50mg again.
Here's to hoping!!
Posted by SLS on August 7, 2006, at 0:54:46
In reply to Re: Lamictal and Topamax, posted by lymom3 on August 6, 2006, at 21:06:50
> When I hit 100mg of the Lamictal I started having unexplained bruising and purple spots.
Unusual bruising is one of the warning signs of a serious reaction known as Stevens-Johnson Syndrome. This is very rare, though.
> Also started having chest pains. I did get checked out by my primary care doc to make sure she couldn't find anything wrong. Once I backed down to 50mg again I haven't had any problems.
I don't know about chest pains specifically, but shortness of breath and rapid heartbeat can be symptoms of this same reaction. So can headache, which you reported. I would proceed with caution.
http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a695007.html
> Pdoc wants to leave me on that because I did have the beginnings of good effects and add Topamax to it.
It is not unusual for people to experience a brief initial improvement at low dosages. This usually disappears, though, and doesn't return until a therapeutic dosage is reached at approximately 200mg.
> I don't know anything about Topamax and am not sure how it should or will augment what help I am getting now.
Topamax is not usually considered to be a drug given to help with depression. However, it seems to have a beneficial effect for some people with bipolar disorder. Although generally considered a mood stabilizer to prevent mania, it has had antidepressant effects for some people.
Topamax is also a particularly effective drug to treat migraines.
- Scott
Posted by SLS on August 7, 2006, at 1:22:18
In reply to Re: Lamictal and Topamax, posted by SLS on August 7, 2006, at 0:54:46
I'm sorry. I was ambiguous. I was referring to Lamictal and not to Topamax:
It is not unusual for people to experience a brief initial improvement to Lamictal at low dosages. This usually disappears, though, and doesn't return until a therapeutic dosage is reached at approximately 200mg.
- Scott
Posted by lymom3 on August 7, 2006, at 7:13:15
In reply to Re: Lamictal and Topamax, posted by SLS on August 7, 2006, at 1:22:18
Where were you when the pdoc was on vacation and I was having problems!!! I did not know the bleeding was SJS. Doc on call never even returned my call or the girl's that works in the office. At this point anything is worth a shot to me so I"ll be a guinea pig and give it a shot.
Thanks for the info on the Lamictal.
Posted by SLS on August 7, 2006, at 7:55:37
In reply to Re: Lamictal and Topamax, posted by lymom3 on August 7, 2006, at 7:13:15
> Where were you when the pdoc was on vacation and I was having problems!!! I did not know the bleeding was SJS.
I guess it would really take an expert to diagnose the SJS in the absence of skin or other epithelial lesions. The other explanation for the bruising, purple spots, and bleeding would be thrombocytopenia (reduced numbers of blood platelets), which is also a possibility with Lamictal. This might be the more likely explanation.
What is your target dosage of Lamictal? I started at 25mg/day and moved up 25mg each week. I was able to completely avoid cognitive side effects this way. You might notice a change in the taste of foods and drinks. I also experienced some mild esophogeal reflux and loose stool. This has subsided with time. Although I have not experienced a true improvement in depression, I have noticed a slight improvement in mental energy.
Good luck with it.
- Scott
Posted by Phillipa on August 7, 2006, at 13:54:31
In reply to Re: Lamictal and Topamax, posted by SLS on August 7, 2006, at 7:55:37
Oh Dear someone else I believe reported the bruisng etc on was it EMSAM? I don't remember. Uggg. Love Phillipa
This is the end of the thread.
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