Posted by JayBTV2 on January 24, 2009, at 10:22:03
In reply to Re: Lamictal versus Depakote, posted by bleauberry on January 23, 2009, at 17:10:21
> Well, it depends on what you want it for. Depression? Add-on to other medication? Anxiety? Mania?
>
> If it is depression, most people would probably >agree Lamictal is the one.
I've been on both and I agree with this. Lamictal has done wonders for my depression (at dosages from 100mg to 150mg). However at times when I've been manic (I get psychotic mania) Depakote has been great at bringing me back to Earth.I haven't taken Depakote in a long while since I haven't had lot of problems with Mania recently. Lamictal has been the cornerstone of my 3med cocktail for two years now.
Incidentally if you happen to use both together be aware that Depakote at dosages >250mg nearly doubles the half-life of Lamictal. Therefore if you use both you have to lower the dosage of Lamictal you take.
As for the rash I think it's greatly over-stated. I go to a lot of bipolar support groups (NAMI/etc) and I've never run into one person who truly had the syndrome....Plus if you titrate even if you get it you'll be fine. http://www.crazymeds.us/lamictal.html has a nice blurb about it see that link (w/ photo) or below....
My .02
-Jay
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The Rash (from crazymeds.us)
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This is a real problem, because Stevens-Johnson syndrome and assorted other serious rashes are bigger concerns with Lamictal (lamotrigine) than any other anticonvulsant, so often Lamictal (lamotrigine) therapy will end at the first sign of any rash. While any rash with Lamictal (lamotrigine) needs to be closely watched, it's the combination of an itching rash and fever with any anticonvulsant that needs immediate attention from a doctor, any doctor. Lamictal (lamotrigine) + itching rash + fever = trip to the emergency room with all of your meds in their original bottles. The following picture is what an actual case of Lamictal-induced Stevens-Johnson syndrome looks like:Image from http://health-pictures.com/rash/lamictal-rash.htm
Image from health-pictures.com
Otherwise it's just call your regular doctor for the soonest appointment possible. Still, I wish everyone would just calm the hell down about The Rash. Yes, it can be fatal, but it usually takes forever to kill you! And I don't mean in a movie-of-the-week, slow, painful death way, I mean that the symptoms show up early and you usually have plenty of time to take action before it's too late. One member of a bipolar support group walked around with an itchy rash and a fever for two weeks before she saw a doctor and she's fine. That was stupid, but not really all that stupid. The rash is slow to kill. Once you see the first symptoms and stop taking Lamictal (lamotrigine), The Rash goes away and you're safe! Problem solved! OK, you'll have truly sucky problem of not being able to take Lamictal (lamotrigine), but that's something else altogether. That doesn't mean you should be lax about any itchy rash and fever, because these skin things have no fixed rate. But the math is pretty simple - if you live in a country where Lamictal is available, you live where the hospitals can deal with The Rash without it being a big deal. Really!
I've received two e-mails from people who have had to be hospitalized because of Stevens-Johnson syndrome. One sent repeatedly in an awful blue font on fuchsia (to either get my attention or just give me a headache) relating how this person ignored the combination of itchy rash and fever for more than three days and wound up in the hospital. And of course blamed Lamictal for all of her woes. The other person is the reason why there are black-box warnings. He added a single 25mg dose of Lamictal to his regimen of Depakote and had to be hospitalized immediately because The Rash hit swiftly. His is the one case in many tens of thousands where it happens that rapidly. In very rare cases The Rash can be a big f*ck*ng deal. That's why there's a black box warning on the PI sheet. More often than not it's stupidity that is the main problem people have. Be annoying with your doctor about rashes and Lamictal. Better safe than sorry.
poster:JayBTV2
thread:875433
URL: http://www.dr-bob.org/babble/20090104/msgs/875781.html