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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by ricker on September 17, 2008, at 18:36:28
Hi all,
Just thought I'd share some "positive" news for a change!
I seem to be functioning quite well with my current cocktail;Zoloft - 50mg
Remeron - 15mg
Clonazepam - 0.5mg / bid
Lamictal - 150mg.The newest addition being Lamictal! I've never tried a mood stabilizer and I must say I've noticed a marked improvement.
As well, my Zoloft has been decreased from 100mg to 50mg.
Strange that a decrease can actually help. Perhaps augmenting Lamictal has been my missing link?
I have noticed a minor increase in irritability, but that seems to be diminishing daily!
Overall, I have more energy, attitude is more positive and I seem to be much stable - less mood fluctuation.
Hoping I can run for awhile with this combination!
I have gained some valuable insight as to treatment options, primarily from reading many post's from this site.
There are some very knowledgeable people here and I certainly appreciate your input.Regards, Rick
Posted by Phillipa on September 17, 2008, at 19:12:12
In reply to Feeling much better with current meds!, posted by ricker on September 17, 2008, at 18:36:28
Ricker well congratulations good news is always great to hear may it continue. Love Phillipa. ps I've noticed my pdoc like lower doses of ad's too.
Posted by Fletcher on September 17, 2008, at 19:58:21
In reply to Feeling much better with current meds!, posted by ricker on September 17, 2008, at 18:36:28
How long have you been on this mix? Keep us all posted.
I've had several "working" mixes in the past, but (for me) they cr*pp*d out after not very long.
Posted by ricker on September 17, 2008, at 22:32:09
In reply to Re: Feeling much better with current meds! » ricker, posted by Fletcher on September 17, 2008, at 19:58:21
> How long have you been on this mix? Keep us all posted.
>
> I've had several "working" mixes in the past, but (for me) they cr*pp*d out after not very long.
Hi Fletcher,
I've only been on this mix for approx. 4 weeks. I took the lamictal up to 150 in that time but my pdoc was okay with it.Oh ya, 20+ years for me too with the good ole poop out?
I must admit though something feels "different" this time. Like I mentioned earlier, I've never been on a mood stabilizer so that may have been half the battle all these years?
And with the current dose I have room to play, so to speak, as both the zoloft and lamictal are set fairly low at the moment.
Time will only tell. I will keep you updated.
Rick
Posted by ricker on September 18, 2008, at 17:28:52
In reply to Feeling much better with current meds!, posted by ricker on September 17, 2008, at 18:36:28
So, I just came from my GP as I began breking out with some acne on my face, nothing to serious though. But, the back of my head at the base looks like a cherry tree!!! What the heck is going on? I finally hit pay-dirt with a med. and I'm a walking zit!
Doc has prescribed me Minocin for the outbreak. I'm only taking 150 mg. of lamictal and I would like to hear from some of you that had this side effect. But I really really want to hear that it's just a startup effect and should subside with time.
Good grief Charlie Brown, I just can't win! :(
Posted by elbee on September 19, 2008, at 13:21:00
In reply to Now what? Lamictal breakout!, posted by ricker on September 18, 2008, at 17:28:52
Darn it! That sounds frustrating! Just when things were looking up. Do you have a pdoc too? If so, maybe you can double check with him/her too about this reaction. I don't know enought to tell you because I've never had this before (I take lamictal). But I do think you should be very cautious. I think it's pretty rare but the skin reactions to lamictal can be pretty serious so I'd monitor carefully. Maybe even discuss with your doc or pdoc whether you should titrate down or discontinue and build back up for a bit. Sorry, I wish I had good news but I just think it wouldn't hurt to be extra careful. Hope it goes away!
Posted by yxibow on September 23, 2008, at 1:42:46
In reply to Now what? Lamictal breakout!, posted by ricker on September 18, 2008, at 17:28:52
> So, I just came from my GP as I began breking out with some acne on my face, nothing to serious though. But, the back of my head at the base looks like a cherry tree!!! What the heck is going on? I finally hit pay-dirt with a med. and I'm a walking zit!
> Doc has prescribed me Minocin for the outbreak. I'm only taking 150 mg. of lamictal and I would like to hear from some of you that had this side effect. But I really really want to hear that it's just a startup effect and should subside with time.
> Good grief Charlie Brown, I just can't win! :(
How fast did you go to get to 150? That's an important point because it takes a loooong time to get there to prove that you dont have the little rash but THE RASH (SJS).Yes, due caution would be here, I would definitely ask your psychiatrist and hope that you can get to see him soon, as a trained MD anyhow to see if that is a Lamictal rash.
Remember, acne breakouts can occur randomly, other medications you take may have done this in the mix, so causation isn't necessarily causality.
Have you been subject to acne in your life? And even adults can have acne outbreaks.How big is the rash too? These are all things I assume your doctor knows about. Or is the "doctor" your psychiatrist instead of a GP in which case disregard the previous.
Minocin is a tetracyclic antibiotic, which could mean he thinks its an acne outbreak, since that is used for that purpose.
Unfortunately Lamictal can cause a rash, less so though if it is titrated up slowly and usually some seborrheic syndrome is noticed early on if its going to happen, before your dose.
Still some individuals do react -- I didn't want to try for a long time but I am now taking it and so far nothing at 250.
There are other AEDs, I don't know if you have tried anything else, most have not many side effects, except Gabitril (seizures I believe, go figure), and Keppra, sometimes causes some psychosis, and Tegretol is not as good as Trileptal in terms of side effects.
-- best wishes
Jay
Posted by ricker on September 23, 2008, at 13:35:01
In reply to Re: Now what? Lamictal breakout!, posted by yxibow on September 23, 2008, at 1:42:46
> How fast did you go to get to 150? That's an important point because it takes a loooong time to get there to prove that you dont have the little rash but THE RASH (SJS).
I may have titrated to fast. Reached 150mg. in 3 weeks.
> How big is the rash too? These are all things I assume your doctor knows about. Or is the "doctor" your psychiatrist instead of a GP in which case disregard the previous.It was my GP that prescibed the Minocin. He did not mention the "rash". He felt it was acne. I hope he is right!
> Unfortunately Lamictal can cause a rash, less so though if it is titrated up slowly and usually some seborrheic syndrome is noticed early on if its going to happen, before your dose.I have lowered my Lamictal to 100mg 3 days ago so I'm hoping the acne will slowly deminish. I usually don't react too bad when adjusting meds, but I must say, lowering the Lamictal from 150 to 100mg., I have become quite irratable and am feeling somewhat down. This, after just 3 days? I think my body is telling me I NEED Lamictal!
> There are other AEDs, I don't know if you have tried anything else, most have not many side effects, except Gabitril (seizures I believe, go figure), and Keppra, sometimes causes some psychosis, and Tegretol is not as good as Trileptal in terms of side effects.
I have not tried other mood stabilizers to date. With any luck, I will adjust to the Lamictal, but it's good to know there are other options if need be.Thanks for taking the time to comment. I appreciate your replies.
Regards, Rick
Posted by Phillipa on September 23, 2008, at 20:43:23
In reply to Re: Now what? Lamictal breakout! » yxibow, posted by ricker on September 23, 2008, at 13:35:01
Ricker didn't you receive a starter pack? Most do and most start at 25mg for two weeks and then 50mg for two weeks and then 100mg. Don't know how fast it goes from there. Love Phillipa
Posted by ricker on September 23, 2008, at 21:57:55
In reply to Re: Now what? Lamictal breakout! » ricker, posted by Phillipa on September 23, 2008, at 20:43:23
> Ricker didn't you receive a starter pack? Most do and most start at 25mg for two weeks and then 50mg for two weeks and then 100mg. Don't know how fast it goes from there. Love Phillipa
No starter pack, 100mg tablets. cut in half and take 50mg for a week, then 100mg for another 2 weeks, then 150mg after 3rd. week?!
Regards, Rick
Posted by Phillipa on September 24, 2008, at 0:03:34
In reply to Re: Now what? Lamictal breakout!, posted by ricker on September 23, 2008, at 21:57:55
Ricker google lamictal it's 25 for two weeks then the 50 and then 100 seriously. Love Phillipa
Posted by azalea on September 24, 2008, at 17:21:35
In reply to Re: Now what? Lamictal breakout!, posted by ricker on September 23, 2008, at 21:57:55
Now that Lamictal is available as generic lamotrigine, I believe the company has discontinued the starter packs. I guess it's do-it-yourself titration. Worth getting a good pill splitter at the drugstore for a few dollars.
If the acne continues to be a problem, perhaps something topical like benzoyl peroxide would be beneficial for prevention so you don't have to take antibiotics frequently.
> > Ricker didn't you receive a starter pack? Most do and most start at 25mg for two weeks and then 50mg for two weeks and then 100mg. Don't know how fast it goes from there. Love Phillipa
>
> No starter pack, 100mg tablets. cut in half and take 50mg for a week, then 100mg for another 2 weeks, then 150mg after 3rd. week?!
>
> Regards, Rick
>
>
>
Posted by Phillipa on September 24, 2008, at 19:49:43
In reply to Re: Now what? Lamictal breakout!, posted by azalea on September 24, 2008, at 17:21:35
Oh really? Didn't know that and that doesn't sound like good thing at all to me. Phillipa
Posted by yxibow on September 25, 2008, at 3:03:14
In reply to Re: Now what? Lamictal breakout! » ricker, posted by Phillipa on September 24, 2008, at 0:03:34
> Ricker google lamictal it's 25 for two weeks then the 50 and then 100 seriously. Love Phillipa
Actually if your doctor is really conservative it could be 25, 50, 75, 100, maybe 150, 200.
Having had this outbreak, which could be coincidental or not, of acne, and a possible drug caused neck rash or maybe that is also part of the acne complex, you may be sensitized more to Lamictal.
I don't know if once one has a rash syndrome, whether they can restart Lamictal again, like the questionability of rechallenging Clozaril, which sometimes can be done and sometimes can't. I'm not sure if it is completely a drug side effect or whether it also "sensitizes" an "allergy".
Hence, you would probably have to drop the medicine completely and wait about two weeks or so for complete washout, maybe a little less. This, as I think you noted before, maybe, yes, will probably cause some irritability. But its for your safety's sake.
SJS is not something you want to have to deal with in the ER, if at all, since its not completely obvious sometimes.
I would suggest with your psychiatrist a complete washout and a very tepid and slow rechallenge, if he/she thinks that it is a good idea or not. If you're still experiencing any sort of rash as you pass 50 or 75, or 100, it is not a good idea unfortunately to use the agent. Its not prudent to risk external and internal serious problems.
I hate to be the bearer of downcast issues but I think its necessary to point these things out.-- best wishes
Jay
Posted by elanor roosevelt on September 26, 2008, at 1:06:10
In reply to Re: Now what? Lamictal breakout!, posted by yxibow on September 25, 2008, at 3:03:14
breaking in lamictal is nasty business
i was mean and miserable
luckily i got to stop at 100mgs and things settledgood luck
Posted by ricker on September 26, 2008, at 18:21:49
In reply to Re: Now what? Lamictal breakout!, posted by yxibow on September 25, 2008, at 3:03:14
> I would suggest with your psychiatrist a complete washout and a very tepid and slow rechallenge, if he/she thinks that it is a good idea or not. If you're still experiencing any sort of rash as you pass 50 or 75, or 100, it is not a good idea unfortunately to use the agent. Its not prudent to risk external and internal serious problems.
>>
> I hate to be the bearer of downcast issues but I think its necessary to point these things out.
>
> -- best wishes
>
> JayThanks for the sound advice Jay. Along with the acne breakout on the back of my head, I have today just noticed a small circular "rash" developing on my left inner thigh!
I don't know if the anxiety and stress I'm currently experiencing is worth it? I have reduced my dose down to 100mg as per p/doc, but I just don't feel "right". It's hard to explain how one minute you can feel so good, only to feel disappointed due to serious side effects (potential).
My p/doc mentioned the possibility of trying abilify if I can not tolerate lamictal. There have been some threads here, hinting one should "avoid" antipyschotics for my type of depression which is probably described as soft bipolar? ... no pyschosis. I experience extreme irratability when depressed and my anxiety hightens.
Right now I am extremely disappointed. I will probably stop the lamictal and increase my clonazepam to help with the withdrawl.
If any one can suggest an altenate mood stabilizer/antipyschotic worth trying, please do. I did try lithium last year but experiened agitation and very bad tremors at 900mg.
What a way to start a weekend. :(
Regards, Rick
Posted by Phillipa on September 26, 2008, at 19:13:36
In reply to Re: Now what? Lamictal breakout! » yxibow, posted by ricker on September 26, 2008, at 18:21:49
Darn Ricker so sorry. Love Phillipa
Posted by ricker on September 28, 2008, at 14:09:08
In reply to Re: Now what? Lamictal breakout! » ricker, posted by Phillipa on September 26, 2008, at 19:13:36
After days of anxiety due to the potential "big rash", I went to the emerg. last night. I showed the Doc. the rash on my thigh ( size of a quarter and circular).
I also informed him of the outbreak on the back of my head the week prior and that I was presribed 1 months supply of Minocin by my GP as he said it was acne.
The E.R. Doc looked at the rash and said, "I worry to much and to quit reading so much on the internet"! OMG! Yes, I'll admit I may worry more than the "normal" person, thats part of my illness!
He said it is not SJS and to continue with Lamictal. I do not see my p/doc untill mid November... quite frustrating.
I find myself more irratable and somewhat obsessed at the momment. Every little itch sends me to the mirror looking for signs of a rash, and believe me, I do feel itchier than normal.I know the Lamictal has helped with my depression and extreme irratability/anger. I am not rapid cycling throughout the day. My wife says I'm much more happier and my kids have even said as much.
I've been trying my hardest to keep positive, I feel like Lamictal is my last hope at recovery. 21 years and I finally am diagnosed with mixed state bipolar, rather than just "depressed"!
Here I sit in front of my computer typing this and all I can think of is that E.R. Doc saying "stay off the internet"! Sorry for the rant, I just want to get better and I'm a bit scared to be honest. I will continue Lamictal and hope he is right.
Regards, Rick
Posted by Nadezda on September 28, 2008, at 17:58:53
In reply to Trip to the E.R. --confused + stressed!, posted by ricker on September 28, 2008, at 14:09:08
Ricker, since SJS is nothing to fool around with, you need to consult someone who is definitely experienced enough to decide whether this is or is not the syndrome. Can't you see your pdoc earlier?
It's not so much that you probably have it, but that the risks are too great in the small chance that you do. And you really shouldn't wait, because the more it advances, the more problematic it becomes.
From what I've read, the rash is circular, like a bull's eye, and people often have symptoms of flu, which you haven't mentioned. My pdoc mentioned it to SJS to me when I considered lamictal and said it really isn't any mystery when you have it-- which I take to be a good sign for you. But of course, however unlikely, you might be noticing some very early stage. I would just do something to resolve the issue, so that you can continue with the lamictal without anxiety, or protect yourself from the problem. It really is the only thing that makes sense at this point.
Nadezda
Posted by Phillipa on September 28, 2008, at 19:47:28
In reply to Trip to the E.R. --confused + stressed!, posted by ricker on September 28, 2008, at 14:09:08
Oh how I relate to that let's see have had melanoma and went to urgent care it disappeared in about a week just broken blood vessels. Web Md was recommended to me by my internist welcome to my world also. Will send a copy to you and also google SJS and see what I think. Love Phillipa
Posted by Phillipa on September 28, 2008, at 20:07:58
In reply to Re: Trip to the E.R. --confused + stressed! » ricker, posted by Nadezda on September 28, 2008, at 17:58:53
Seems that you will be fine didn't know antibiotics can also cause it. Phillipa
Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis
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Pronunciations
allopurinol
barbiturates
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corticosteroid
dermatitis
granuloma
immunoglobulin
phenytoin
psoriasis
rosacea
toxic epidermal necrolysis
urethra
Stevens-Johnson syndrome and toxic epidermal necrolysis are two forms of the same life-threatening skin disease that cause rash, skin peeling, and sores on the mucous membranes.In Stevens-Johnson syndrome, a person has blistering of mucous membranes, typically in the mouth, eyes, and vagina, and patchy areas of rash. In toxic epidermal necrolysis, there is a similar blistering of mucous membranes, but in addition the entire top layer of the skin (the epidermis) peels off in sheets from large areas of the body. Both disorders can be life threatening.
Nearly all cases are caused by a reaction to a drug, most often sulfa antibiotics; barbiturates; anticonvulsants, such as phenytoin Some Trade Names
DILANTIN
and carbamazepine Some Trade Names
TEGRETOL
; certain nonsteroidal anti-inflammatory drugs (NSAIDs); or allopurinol Some Trade Names
LOPURIN
ZYLOPRIM
. Some cases are caused by a bacterial infection. Occasionally, a cause cannot be identified. The disorder occurs in all age groups but is more common among older people, probably because older people tend to use more drugs. The disorder is also more likely to occur in people with AIDS.Symptoms
Stevens-Johnson syndrome and toxic epidermal necrolysis usually begin with fever, headache, cough, and body aches. Then a flat red rash breaks out on the face and trunk, often spreading later to the rest of the body in an irregular pattern. The areas of rash enlarge and spread, often forming blisters in their center. The skin of the blisters is very loose and easy to rub off. In Stevens-Johnson syndrome, less than 10% of the body surface is affected. In toxic epidermal necrolysis, large areas of skin peel off, often with just a gentle touch or pull. In many people with toxic epidermal necrolysis, 30% or more of the body surface peels away. The affected areas of skin are painful, and the person feels very ill with chills and fever. In some people, the hair and nails fall out. The active stage of rash and skin loss can last between 1 day and 14 days.
In both disorders, blisters break out on the mucous membranes lining the mouth, throat, anus, genitals, and eyes. The damage to the lining of the mouth makes eating difficult, and closing the mouth may be painful, so the person may drool. The eyes may become very painful, swell, and become so filled with pus that they seal shut. The corneas can become scarred. The opening through which urine passes (urethra) may also be affected, making urination difficult and painful. Sometimes the mucous membranes of the digestive and respiratory tracts are involved, resulting in diarrhea and difficulty breathing.
The skin loss in toxic epidermal necrolysis is similar to a severe burn and is equally life threatening. Huge amounts of fluids and salts can seep from the large, raw, damaged areas. A person who has this disorder is very susceptible to organ failure and infection at the sites of damaged, exposed tissues. Such infections are the most common cause of death in people with this disorder.
Treatment
People with Stevens-Johnson syndrome or toxic epidermal necrolysis are hospitalized. Any drugs suspected of causing the disorder are immediately discontinued. When possible, people are treated in a burn unit and given scrupulous care to avoid infection. If the person survives, the skin grows back on its own, and unlike burns, skin grafts are not needed. Fluids and salts, which are lost through the damaged skin, are replaced intravenously.
Use of corticosteroids to treat the disorder is controversial. Some doctors believe that giving large doses within the first few days is beneficial, whereas others believe that corticosteroids should not be used. These drugs suppress the immune system, which increases the potential for serious infection. If infection develops, doctors give antibiotics immediately.
In many cases, doctors give intravenous human immunoglobulin (IVIg) to treat toxic epidermal necrolysis. This substance helps to prevent further immune damage to the skin and further progression of blistering.
Posted by azalea on September 28, 2008, at 21:01:49
In reply to Trip to the E.R. --confused + stressed!, posted by ricker on September 28, 2008, at 14:09:08
Lamictal can cause rashes that are NOT SJS. I recommend this website to read about how to manage a rash while taking Lamictal:
http://www.psycheducation.org/depression/meds/LamRash.htmAs the above website recommends, perhaps an appointment with a dermatologist would be a good idea. GPs are great for general medical problems. ER docs know a lot about emergencies. But a dermatologist is going to be your best bet for diagnosing and treating this rash. If acne is a side effect of the Lamictal, the dermatologist can probably give you a topical treatment to prevent further breakouts.
Lamictal is a great medication and it sounds like you and your family have noticed improvement in your mood. Don't give up on it just yet!
> After days of anxiety due to the potential "big rash", I went to the emerg. last night. I showed the Doc. the rash on my thigh ( size of a quarter and circular).
> I also informed him of the outbreak on the back of my head the week prior and that I was presribed 1 months supply of Minocin by my GP as he said it was acne.
> The E.R. Doc looked at the rash and said, "I worry to much and to quit reading so much on the internet"! OMG! Yes, I'll admit I may worry more than the "normal" person, thats part of my illness!
> He said it is not SJS and to continue with Lamictal. I do not see my p/doc untill mid November... quite frustrating.
> I find myself more irratable and somewhat obsessed at the momment. Every little itch sends me to the mirror looking for signs of a rash, and believe me, I do feel itchier than normal.
>
> I know the Lamictal has helped with my depression and extreme irratability/anger. I am not rapid cycling throughout the day. My wife says I'm much more happier and my kids have even said as much.
>
> I've been trying my hardest to keep positive, I feel like Lamictal is my last hope at recovery. 21 years and I finally am diagnosed with mixed state bipolar, rather than just "depressed"!
>
> Here I sit in front of my computer typing this and all I can think of is that E.R. Doc saying "stay off the internet"! Sorry for the rant, I just want to get better and I'm a bit scared to be honest. I will continue Lamictal and hope he is right.
>
> Regards, Rick
Posted by Phillipa on September 28, 2008, at 21:11:35
In reply to dermatologist » ricker, posted by azalea on September 28, 2008, at 21:01:49
Good link but didn't Ricker say he's seen a dermatologist? I certainly could be mistaken. Phillipa
Posted by yxibow on September 29, 2008, at 0:42:58
In reply to Trip to the E.R. --confused + stressed!, posted by ricker on September 28, 2008, at 14:09:08
> After days of anxiety due to the potential "big rash", I went to the emerg. last night. I showed the Doc. the rash on my thigh ( size of a quarter and circular).
> I also informed him of the outbreak on the back of my head the week prior and that I was presribed 1 months supply of Minocin by my GP as he said it was acne.
> The E.R. Doc looked at the rash and said, "I worry to much and to quit reading so much on the internet"! OMG! Yes, I'll admit I may worry more than the "normal" person, thats part of my illness!
> He said it is not SJS and to continue with Lamictal. I do not see my p/doc untill mid November... quite frustrating.
> I find myself more irratable and somewhat obsessed at the momment. Every little itch sends me to the mirror looking for signs of a rash, and believe me, I do feel itchier than normal.
>
> I know the Lamictal has helped with my depression and extreme irratability/anger. I am not rapid cycling throughout the day. My wife says I'm much more happier and my kids have even said as much.
>
> I've been trying my hardest to keep positive, I feel like Lamictal is my last hope at recovery. 21 years and I finally am diagnosed with mixed state bipolar, rather than just "depressed"!
>
> Here I sit in front of my computer typing this and all I can think of is that E.R. Doc saying "stay off the internet"! Sorry for the rant, I just want to get better and I'm a bit scared to be honest. I will continue Lamictal and hope he is right.
>
> Regards, Rick> After days of anxiety due to the potential "big rash", I went to the emerg. last night. I showed the Doc. the rash on my thigh ( size of a quarter and circular).
> I also informed him of the outbreak on the back of my head the week prior and that I was presribed 1 months supply of Minocin by my GP as he said it was acne.
> The E.R. Doc looked at the rash and said, "I worry to much and to quit reading so much on the internet"! OMG! Yes, I'll admit I may worry more than the "normal" person, thats part of my illness!
> He said it is not SJS and to continue with Lamictal. I do not see my p/doc untill mid November... quite frustrating.
> I find myself more irratable and somewhat obsessed at the momment. Every little itch sends me to the mirror looking for signs of a rash, and believe me, I do feel itchier than normal.
>
> I know the Lamictal has helped with my depression and extreme irratability/anger. I am not rapid cycling throughout the day. My wife says I'm much more happier and my kids have even said as much.
>
> I've been trying my hardest to keep positive, I feel like Lamictal is my last hope at recovery. 21 years and I finally am diagnosed with mixed state bipolar, rather than just "depressed"!
>
> Here I sit in front of my computer typing this and all I can think of is that E.R. Doc saying "stay off the internet"! Sorry for the rant, I just want to get better and I'm a bit scared to be honest. I will continue Lamictal and hope he is right.
>
> Regards, RickWell, not to sound banal, but if you went to an emergency room and they looked at you for Stevens-Johnson and did not find anything that related to it, SJS is not something that an ER doctor hasn't seen before and I'm not actually going to point out where one can see what it really is, because that will scare the both of us, considering I already take Lamictal.
Sometimes information sources on the Internet are useful, and sometimes we get "medical student syndrome", that is, literally medical students having studied so many thing begin to think that they have half a dozen disorders.
So its really up to you -- I can't say anything more about it -- you can seek more dermatologists' opinions, but you already walked into an emergency room where someone with burn victim signs would be directed to the appropriate place.
Sometimes we have somatic experiences with worry. Lamictal is not the only medication, it can be idiopathic, there are a number of things that yes, are on the Internet.
I understand your fear regarding this -- does your psychiatrist have any pager/emergency #, and if so have you been in contact with he/she to see if an appointment time in their availability can be squeezed in?
If his or/her answer is to drop the Lamictal after you describe a concise description and not every single mark -- I'm not trying to be mean -- everybody has acne, I have little vascular marks, rashes, bites, cut scars, all the time just like everyone else that are not SJS -- then that is what you will have to do until you can see your p-doc at a regular appointment to go further as to what to do.
There is a laundry list of other AEDs that can be tried for augmentation, some people respond to them, some don't, just like Lamictal.
If you drop it AMA (against medical advice) because you are so worried, I can't say anything about that and I really shouldn't actually say that because I'm not suggesting necessarily, I am not your doctor.
There are other rashes besides SJS that Lamictal can cause and you may have concommitant dermatitis unrelated as well.
-- best wishes
Jay
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