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Re: Lithium or Lamictal rash?? » katia

Posted by Ron Hill on January 5, 2004, at 15:15:12

In reply to Lithium or Lamictal rash?? » Ron Hill, posted by katia on January 4, 2004, at 1:56:56

Hi Katia,

> I noticed on one of your posts you said you developed the rash on Lamictal. I just developed a rash this morning. I'm on 200mg of lam for over a month and over four months on it total. I started Lithium 2 weeks ago and just upped the total dose to 900mg in the evening two days ago. This rash is sore and is like poison oak and is on my arms, inner thighs, stomach and chest. And it hasn't gone away upon awakening. My pdoc is taking me off of Lamcital but I'm wondering if it's not the Lithium???

My initial reaction is to agree with you and wonder if lithium is causing the rash. If you have been taking Lamictal for four months without a rash problem, and then two weeks after starting lithium, a rash shows up, the first thing I would look at is the possibility that lithium (or lithium in the presence of Lamictal) is causing the rash. If Lamictal were the culprit, I would think that it would have showed up very soon after starting the medication. On the other hand, you description of your rash sounds a lot like the rash I had on Lamictal. But all this is just my layman's opinion. You pdoc knows more than I do.

Currently, I typically take 300 mg/day of Lithobid. However, if I start to feel a little hypomanic, I raise my daily dosage to 450 mg or 600 mg. Lithobid causes a rash for me, primarily on my face. The severity of the rash seems to increase as I increase the lithium dosage. However, the severity of the rash also seems to change periodically (for some unknown reason) without changing the lithium dosage. Go figure! At any rate, I work with my dermatologist to keep the problem in check. The rash caused by Lithobid is no where near as bad as the rash I had with Lamictal.

As an aside, 900 mg/day of lithium seems like a large dose for you. If my memory serves me right, you are bipolar II (not BP I), correct? If I were in your shoes, I would chat with your pdoc about the possibility of reducing your lithium dosage to; say about 600 mg/day. A lot of research indicates that low doses of lithium are actually neuroprotective. However, high levels of lithium pose a higher risk of thyroid damage, etc. Just a thought.

> You said severe? What is that? My rash is pretty much covering most of my body and I"m scared.

Severe in that several blotches of rash occurred over a sizeable portion of my body. My rash was not SJS, however.

> Did you have a sore throat?

No

> Did the rash hurt and feel tight like?

No.

> Were there tiny bumps?

No, scaly.

Did it itch?

YES! Like crazy.

> I'm worried this is the severe one. How long did it last?

Until I quit taking Lamictal. Depakote gave me a similar rash, just not as pervasive.

-- Ron


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