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Re: Lamictal combo for everything? » Sheilac

Posted by SLS on September 19, 2012, at 7:59:02

In reply to Lamictal combo for everything?, posted by Sheilac on September 19, 2012, at 6:13:38

> My doc is nuts I think. He said since I didn't get the rash after the first month, he wanted me to jump from 50mg up to 150mg for a week, then 200mg the next week. That is a fast jump. I was taking it slow by going up to 75mg, but yesterday after he was gruff with me on the phone I jumped up to 100mg.

Your doctor is right about the schedule of dosage titration. However, this is what is prescribed for the average patient. You may not be the average patient, though.

> He took me off everything else - Trileptal and lithium.

You have reported that Trileptal makes you feel more depressed. Do you think Lamictal might prevent this from happening? You might want to ask your doctor about using an antipsychotic as a mood-stabilizer.

How often does your doctor see Trileptal making his patients more depressed? I am surprised by your reaction, but chances are that you are not unique. Of course, there are other anticonvulsant mood stabilizers you can try. If your doctor opts for Depakote, just be sure to cut your dosage of Lamictal in half. That would leave you at 100 mg/days instead of 200 mg/day.

> But this last jump in dose produced weird itchy gums.

This is a significant reaction that must be watched. Chances are that this will pass. With me, itchy eyes occurred with every dosage increase. However, the mouth is where Stevens-Johnson Syndrome (SJS) usually begins. If it were me, I would continue with the Lamictal and monitor closely your itching gums. If it gets worse or spreads instead of getting better at a steady dosage, you should contact your doctor and express your concerns about SJS. SJS is uncommon, so I wouldn't get too worried about getting it just yet.

> Is it possible to go back to 50mg Lamictal and use lithium and or Trileptal?

Yes.

The same is true of antipsychotics. I am not sure which one makes sense for you as a first choice. Because of your anxiety and insomnia, Seroquel might be worth inquiring about. I like Abilify with Lamictal. Many people experience restlessness and insomnia in the beginning, but this usually disappears, leaving one less depressed with reduced anxiety.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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