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Lamictal Rashes henryo

Posted by Quintal on April 25, 2008, at 20:41:34

In reply to reality, posted by henryo on April 25, 2008, at 19:34:06

I don't understand why you're holding me personally to account for the statistics printed on a webpage. These are not my own person claims on the incidence of Lamictal rash, not some wild figure I just picked out of hat. Something doesn't seem to be registering here. As I explained, according to the website the one in ten figure is the overall incidence of benign non-serious rash, which seems to be fairly common. The smaller figures are serious SJS-like reactions, which are very rare. It's as simple as that.

Again, I find even on the weblinks you provided, the 0.3% rate you quoted is only for serious rash. Further down he has a chart showing the overall incidence of rash, which is as high as 13% in one dosage range. As the author says below, using slow titration methods they managed to lower the incidence of *benign* rash (author's emphasis) to 3%, as opposed to the typical rate of 10% (1 in 10) usually found in other research studies. There were no *serious* rashes in this group studied.

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Thus my main strategy on "handling the rash" is to try to avoid it in the first place. [Update 5/2005: Stanford's Bipolar Clinic, led by Dr. Terry Ketter, published their results from a strategy in which they warned patients not to add any new allergens: no new soaps, detergents, cosmetics, shaving creams, deodorants, etc; no new foods; and avoiding sunburn or poison oak. They also waited to start if the patient had recently had a rash, symptoms of a viral infection, or a rash. Using this strategy, they lowered the benign rash rate -- there were no serious rashes in this group of 100 patients -- to 3%, versus the common 10% rate for rash in other lamotrigine research studies.Ketter][Update 2008: when they repeated that strategy with the pharmacist giving the skin instructions, the difference in rash rates was not significant.Ketter (b) Ketter says he still gives the same instructions, despite those data.]
http://www.psycheducation.org/depression/meds/LamRash.htm
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Also, the paragraph above the one you cut & pasted from this webpage (http://www.pslgroup.com/dg/eb8ea.htm) quotes these statistics:
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Nine clinical trial participants discontinued due to rash, seven out of 129 in the lamotrigine group and two out of 66 in the placebo group, although none of the rashes were considered serious nor did patients require hospitalisation.
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So, if we take 7, divide it by 129, multiply the result by 100, that gives us 5.42% for the incidence of benign rash in the lamotrigine group of this study. You seem to have omitted the part that distinguishes between benign and serious rash - indeed you left out the statistics for benign rash altogether.

I'm getting sick of this subject. I had no intention of sparking such a debate when I quoted the figures in my original post, nor was I trying to scare people away from taking lamotrigine. It was just an innocent comment. I never expected it to receive this much scrutiny.

Q


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poster:Quintal thread:822705
URL: http://www.dr-bob.org/babble/20080420/msgs/825502.html