Psycho-Babble Medication | about biological treatments | Framed
This thread | Show all | Post follow-up | Start new thread | List of forums | Search | FAQ

Lamictal restart dosage help

Posted by Sulpicia on January 28, 2001, at 15:42:36

Sorry in advance to anyone who's read this b4; I posted this earlier on the kiddie forum.

Hi Folks --
I have one horribly depressed 15 y/o with bipolar II dx. She was doing really well on wellbutrin and lamictal. Alas:
a week or so after we moved to 150mgs during a nice slow and by the books increase, she developed an actinic
rash and mouth ulcers. We took her off for nine frantic days while I tracked down and read *everything* written
about lamictal, lamictal and wellbutrin, SJS, TENS, actinic rashes, restarts, you name it. Rash went away w/in 24
hrs of starting prednisone. No biopsy [I read the derm stuff last like an idiot] so no confirmation other than
hypersensitivity. In view of the facts that: she didn't respond to depakote at all [8 wks therapeutic level] and was
rendered unconscious after 36 hrs by starting dose of lithium, had 4 p-hospitalizations and nearly died, we
decided to restart the lamictal. There is virtually no data here for us to work with. I know the rule: start low and go
slow. So far so good and up to 25mgs w/out problems. Am checking temp, lymph nodes, and skin. *Frequently*
Her severe depression returned w/in 24 hrs of stopping lamictal and has not shown any signs of letting up. Terrible
hypersomnia, 22 hrs per day, sadness, apathy, hunger, unable to eat, bathe or do anything. Once last week she
was able to stay awake for 24 hrs straight and made it to school. For one day out of the last 2 wks. Not a bad
strategy to use sleep deprivation to combat depression. Anyway, at the safe rate of increase she will be at the
level were she got relief in about 6 wks. She'll never make it. Pdoc tried provigil to no effect. This morning we
were down to 2 choices: try adding adderall [tricky at best w/ BP II and recent substance abuse remission] , or
exceed the traditional increase rate and pray. Started adderall 20mgs this AM; couldn't get up until severely
harrassed and threatened, and only managed 4 hrs awake. No mania tho or drug cravings. Thank god for AA.

So, here's the question: I need experiential, or best guess, or even ethical calculus input here -- how fast can we
increase the lamictal?

And yes, just in case you're wondering, I *do* realize that we're playing with fire but the situation is dire. Pdoc is
fabulous, highly experienced but there is simply no available data on which to make a decision. We're reluctant to
do a faster increase but also horrified of relapse. Between a rock and hard place indeed.

Any and all input appreciated.




Post a new follow-up

Your message only Include above post

Notify the administrators

They will then review this post with the posting guidelines in mind.

To contact them about something other than this post, please use this form instead.


Start a new thread

Google www
Search options and examples
[amazon] for

This thread | Show all | Post follow-up | Start new thread | FAQ
Psycho-Babble Medication | Framed

poster:Sulpicia thread:52762