Posted by katia on July 28, 2003, at 14:06:09
In reply to Re: Lamictal Rash? question, posted by Emme on July 28, 2003, at 5:32:31
> Hi. I'm sort of on a Psycho Babble posting vacation. But I happened to pop in to read and saw this thread and felt compelled to put in a word.
>
> I have to agree with Henry O that your pdoc may be overly cautious in this matter. Has he/she had some sort of bad experience with another patient on Lamictal? It's a god drug and you have to weigh the low risks of SJS with the risks of a serious mood disorder. (I don't mean in any way to minimize the horribleness of SJS).
>
> I take Lamictal and tolerate it well. I have had something like four rashes while titrating slowly. I saw a dermatologist for the first one, and my pdoc consulted an expert on this drug, who recommended retrying it. I get the impression that you can get more than one type of non-SJS rash with Lamictal. Mine were a single small (2") smooth pink patch that disappeared within 24 hours. One was a flushing reaction on my upper chest that disappeared within about 6 hours (I called the dermatologist again about that one).
>
> There is precedent in the medical literature for retrying Lamictal succesfully after the resolution of a harmless rash. Keep the titration slow and if you see anything rash-like, tell your doctor and consult a dermatologist. If it looks nasty, head for the ER. Be alert and careful. But if you're an adult, are not simultaneously taking Depakote, and titrate at 12.5 mg/week or less, your risk of SJS is minimized.
>
> EmmeThanks Henry and Emme,
Emme, so you stopped it the first rash? For how long? And when you restarted it you got the following three rashes without stopping it again? and they just went away?
This is all so confusing because I do trust my pdoc and I feel like I should do what he suggests to start with, which is Depakote. But apparently there is the risk of that deadly rash with Depakote too. to my knowledge, he has had about two people that developed the rash (and it went away when they got off) and one person on Depakote (and it went away). So no seriously bad experiences as far as I know.
His other reasoning to start with Depakote is that it's "tried and true" as a pretty good mood stabilizer. And that his rationale is this will hopefully even out the "ups" so that I won't crash into the "downs". (even tho' my main problem is the down side) and that to see this result takes at least the length of a cycle. He works a lot with bipolar people and is pretty well known and respected. (i've been dxed as BP NOS - falling somewhere in between mixed and II).
Thanks for your input. I needed some reassurance!
Katia
poster:katia
thread:245522
URL: http://www.dr-bob.org/babble/20030728/msgs/246184.html