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Dr. Bob is Robert Hsiung, MD,
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Posted by bissie66 on July 26, 2003, at 11:34:18
i just started lamictal this morning. i am feeling better. is it possible it's started working already? how long did it take for others who use it to kick in? did anyone get the dreaded rash?
fyi - i was prescribed this for bipolar 2. i also take zoloft 125 mg. for depression and serax (sp?) for anxiety (10 mg. 3x a day). hopefully i won't need the serax (and maybe the zoloft?) if the lamictal works.
thanks for any comments.
Posted by maxime on July 26, 2003, at 15:54:23
In reply to Lamictal question, posted by bissie66 on July 26, 2003, at 11:34:18
well I am usually one who thinks that any is possible (within reason). Lamictal isn't really a fast acting med. Usually you have to build up the dosage. Some people have reported that it makes them speedy so perhaps that is what you are feeling. So yeah, if your aim was to feel more "up" then I guess it is making you feel better. But if it's to stabilise your mood because you are bipolar, up isn't always a good thing (speaking from personal experience).
Watch out for mania, OK?
Max
Posted by bissie66 on July 26, 2003, at 16:32:01
In reply to Re: Lamictal question, posted by maxime on July 26, 2003, at 15:54:23
Thanks, Max. yes, i think i'm feeling a bit speedy and that does feel good compared to depression. but i'm not obsessing, ruminating, or worrying like i have been. Thanks again.
> well I am usually one who thinks that any is possible (within reason). Lamictal isn't really a fast acting med. Usually you have to build up the dosage. Some people have reported that it makes them speedy so perhaps that is what you are feeling. So yeah, if your aim was to feel more "up" then I guess it is making you feel better. But if it's to stabilise your mood because you are bipolar, up isn't always a good thing (speaking from personal experience).
>
> Watch out for mania, OK?
>
> Max
Posted by HenryO on July 27, 2003, at 3:14:13
In reply to Lamictal question, posted by bissie66 on July 26, 2003, at 11:34:18
Are you building up slow like they tell you to? I was told to go up by 25mg a week or slower. I did not get any rashes. Some people get headaches from it at first. Somebody on this site told me to take it every 12 hours or risk headache at the 19 hour mark. That helped a lot. I have no headache issues now though. I am currently at 200mg daily. I have to take it with food or I get a gripe in my stomach. I think it is the best AD I've every been on and I've been on too many. Also I have a libido again. I did not start to feel better until around 100-125 but we are all so diferent. I am toying with the idea of moving my dose higher just to see if more is better. To date it has been very good. I think you're gonna like it. It allowed me to go off my cocktail. I am doing Lamictal only now. Once again your milage may vary. Good luck
Posted by katia on July 27, 2003, at 16:36:44
In reply to Re: Lamictal question, posted by HenryO on July 27, 2003, at 3:14:13
Has anyone on this board gotten that rash associated with Lamictal and it never went away? That is one reason why my pdoc doesn't want to start me with Lamictal due to the small possibility of developing the rash that never goes away even when discontinuing the med. And I really want to try it as there have been so many positive results. Anyone know of anyone who actually died of this rash?
Posted by River1924 on July 27, 2003, at 21:11:16
In reply to Lamictal Rash? question, posted by katia on July 27, 2003, at 16:36:44
Click on SJS Pictures at the site provided.
http://hometown.aol.com/sjsupport/
It is a minor possiblity but the pictures may explain your doc's reluctance. If I had seen these pix I don't know if I'd have tried zonegran or lamictal. Probably.
Posted by katia on July 28, 2003, at 2:10:20
In reply to Re: Lamictal Rash? question, posted by River1924 on July 27, 2003, at 21:11:16
> Click on SJS Pictures at the site provided.
>
> http://hometown.aol.com/sjsupport/
>
> It is a minor possiblity but the pictures may explain your doc's reluctance. If I had seen these pix I don't know if I'd have tried zonegran or lamictal. Probably.Well, that does it. I don't want either Lamictal or Depakote now. I'm totally distressed now because there is nothing now that can help me! I can't risk getting that rash! that was horrendous. those poor poor people. Isn't bad enough to suffer from this? much less get something so god awful like that rash when you're just trying to help yourself?????
really - don't know what to do now. It's too frightening.
Posted by HenryO on July 28, 2003, at 4:22:38
In reply to Lamictal Rash? question, posted by katia on July 27, 2003, at 16:36:44
Lamictal has been the best by far of any med I've ever taken. Works as advertised, no side effects.
Those photos are awful but you take a small amount of Lamictal and build up slowly watching for any signs of trouble. I did not see anything that claimed Lamictal caused those particular rashes. I have never heard of it never going away either. Your doctor is being overly cautious. I have seen one person on this whole site claim they got a skin reaction and they quit the med, no problems.
The whole thing with Lamictal was that when it was first prescribed for epilepsy years ago they just jumped right in at 200-400mg. If a person was sensitive to it they got broadsided.
Try it. After it gets up to 150-250 it works very well. You just start small and move up slow any problems quit taking it.
Posted by Emme on July 28, 2003, at 5:32:31
In reply to Lamictal Rash? question, posted by katia on July 27, 2003, at 16:36:44
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.
Emme
Posted by River1924 on July 28, 2003, at 13:40:04
In reply to Lamictal Rash? question, posted by katia on July 27, 2003, at 16:36:44
I didn't mean you shouldn't get the appropriate treatment. A serious mood disorder is just as serious as SJS and far more likely to ruin your life or destroy it. I agree with "HenryO" and "Emme." Lamictal isn't evil and can be very helpful. You should just use caution. All I meant was, your doctor has probably seen the worst of the worst in med school and is probably rash-phobic. The truth is many drugs and foods and the trillion chemicals around us can cause a rash. Very few cases will ever progress to the level seen in those pictures. If you want to try lamictal, you need to reassure your doctor that you have 'seen' what could happen if you let a rash or reaction get by unnoticed and that you will, without a doubt, get medical attention. Some people, including myself, raise and lower and stop and mix and match meds far too much...as if they are "mood candy." Pictures like that of people who have had terrible reactions to various meds remind me to be more careful. You be careful BUT treat your mood disorder.
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
Posted by katia on July 28, 2003, at 14:09:29
In reply to Sorry, didn't mean to freak you out » katia, posted by River1924 on July 28, 2003, at 13:40:04
> I didn't mean you shouldn't get the appropriate treatment. A serious mood disorder is just as serious as SJS and far more likely to ruin your life or destroy it. I agree with "HenryO" and "Emme." Lamictal isn't evil and can be very helpful. You should just use caution. All I meant was, your doctor has probably seen the worst of the worst in med school and is probably rash-phobic. The truth is many drugs and foods and the trillion chemicals around us can cause a rash. Very few cases will ever progress to the level seen in those pictures. If you want to try lamictal, you need to reassure your doctor that you have 'seen' what could happen if you let a rash or reaction get by unnoticed and that you will, without a doubt, get medical attention. Some people, including myself, raise and lower and stop and mix and match meds far too much...as if they are "mood candy." Pictures like that of people who have had terrible reactions to various meds remind me to be more careful. You be careful BUT treat your mood disorder.
thanks I needed that. Have you tried other mood stablizers? like Depakote?
katia
Posted by starlight on July 28, 2003, at 15:14:25
In reply to Lamictal Rash? question, posted by katia on July 27, 2003, at 16:36:44
I developed a small pinprick rash on my torso and inner thighs that went away. No problemo.
starlight
Posted by bissie66 on July 28, 2003, at 19:46:18
In reply to Re: Lamictal question, posted by HenryO on July 27, 2003, at 3:14:13
yes, I am increasing slowly. thanks for your response. it's very, very encouraging. i haven't had headaches or any other bothersome side effects yet. it's only been a few days but i'm feeling better already, even though i'm in the middle of a very difficult family situation. i have high hopes for this med.
> Are you building up slow like they tell you to? I was told to go up by 25mg a week or slower. I did not get any rashes. Some people get headaches from it at first. Somebody on this site told me to take it every 12 hours or risk headache at the 19 hour mark. That helped a lot. I have no headache issues now though. I am currently at 200mg daily. I have to take it with food or I get a gripe in my stomach. I think it is the best AD I've every been on and I've been on too many. Also I have a libido again. I did not start to feel better until around 100-125 but we are all so diferent. I am toying with the idea of moving my dose higher just to see if more is better. To date it has been very good. I think you're gonna like it. It allowed me to go off my cocktail. I am doing Lamictal only now. Once again your milage may vary. Good luck
Posted by katia on July 29, 2003, at 1:32:56
In reply to Re: Katia Lamictal Rash? , posted by HenryO on July 28, 2003, at 4:22:38
> Lamictal has been the best by far of any med I've ever taken. Works as advertised, no side effects.
>
> Those photos are awful but you take a small amount of Lamictal and build up slowly watching for any signs of trouble. I did not see anything that claimed Lamictal caused those particular rashes. I have never heard of it never going away either. Your doctor is being overly cautious. I have seen one person on this whole site claim they got a skin reaction and they quit the med, no problems.
>
> The whole thing with Lamictal was that when it was first prescribed for epilepsy years ago they just jumped right in at 200-400mg. If a person was sensitive to it they got broadsided.
>
> Try it. After it gets up to 150-250 it works very well. You just start small and move up slow any problems quit taking it.
>
Hi Henry,
What else have you tried? What is your dx? I've heard that just Lamictal alone can make one too racy. Is this all you are on? It's very tempting to try this med and forget about Depakote. My dx is BP NOS (not otherwise specified). And after a year of trying ADs to no avail, my dx changed from depression to bipolar. I have yet to try any mood stabilizers, but am waiting to receive my depakote in the mail from Canada. Lamictal seems like it would be good for me!
Can you tell me a little of your experience?
thanks.
Katia
Posted by HenryO on July 29, 2003, at 2:33:47
In reply to Re: Katia Lamictal Rash? » HenryO, posted by katia on July 29, 2003, at 1:32:56
I have tried so many meds over the last 15 years that I get kinda sad thinking about it. DX would be treatment resistent depression. I don't have anything like mania. I have not found Lamictal to be "racy" for me. I still ocasionally take Ritalin. But, I would say that Lamictal is the only med I'm "on". I hold some Pindolol in reserve for the rare ocassions when my brain catches on fire.I have never tried depakote. I don't think I will though. You can see from my earlier post what I think of Lamictal. I still have low days even weeks but I am feeling consistantly better than I ever have. Did I cover all your questions? I'll be happy to expound. I can go on and on.
Posted by Emme on July 29, 2003, at 22:14:23
In reply to Re: Lamictal Rash? question » Emme, posted by katia on July 28, 2003, at 14:06:09
> > 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.
> >
> > Emme
>
> Thanks 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
>Katia,
I stopped Lamictal after the first rash long enough to try several weeks each of trileptal and gabitril, neither of which worked out. I stayed on Lamictal during the other rashes. They all disappeared so fast (> 24 hours). On the second round with Lamictal we kept the titration super slow - about 7.5 mg/week.
As for tried and true, Lamictal seems to be gaininga lot of popularity, so the collective experience is building up too. The poop-out thing scares me - seems to be a lot of that described here. I just had a consult/2nd opinion with a very experienced psychopharamacologist. He said that it is possible to achieve and maintain an optimal dosage. Maybe all those people just aren't posting here. :) I'm keeping my fingers crossed.
Good luck.
Emme
Posted by katia on July 29, 2003, at 22:34:44
In reply to Re: Lamictal Rash? question » katia, posted by Emme on July 29, 2003, at 22:14:23
Posted by HenryO on July 30, 2003, at 0:46:06
In reply to fingers crossed here for you too (nm) » Emme, posted by katia on July 29, 2003, at 22:34:44
I have been on Lamictal over a year now and I don't sense any poop out.
Posted by bissie66 on July 30, 2003, at 18:32:20
In reply to Lamictal question, posted by bissie66 on July 26, 2003, at 11:34:18
thanks everyone. so glad for this board. so many smart, well-informed posters.
i have been on lamictal 5 days. i am taking 50 mg. once a day for 2 weeks, then 50 mg. twice a day for 2 weeks, then I see my pdoc.
my question is this: should i split my 50 mg. into two doses of 25 mg. each? (i can cut the tablets). it seems that's how it's most often done, and i have noticed that by late afternoon/evening my moods are way up and down. granted, i am going thru a hard time, but in one hour i go from feeling very positive, hopeful, and grateful to hopeless and crying. these swings continue through the late afternoon, evening, and night. the moods change several times an hour. could just be what i'm going through in my life situation though. any input would be helpful. thank you.
Posted by HenryO on July 31, 2003, at 1:28:37
In reply to another Lamictal question, posted by bissie66 on July 30, 2003, at 18:32:20
I was told to go up by a maximum of 25mg a week. That's what I was told to do. As for spliting the dose into A.M. and P.M., I think it helps. Not so much with mood, at that dose I'm not sure it matters, but for me it helped reduce some headaches I was having.
Posted by psychomotor on October 9, 2003, at 14:07:10
In reply to Re: another Lamictal question, posted by HenryO on July 31, 2003, at 1:28:37
Belive it or not i am was just on 500mg in the morning and 500mg at night.... just went down to 450... a rash has formed on my neck and chest, no itching yet but a bit scary.
Posted by katia on October 9, 2003, at 14:20:56
In reply to Re: another Lamictal question » HenryO, posted by psychomotor on October 9, 2003, at 14:07:10
Hi,
I would DEFINITELY tell your doctor about the rash. and soon. It's not something you want to take a chance with.
Katia
Posted by katia on October 9, 2003, at 14:25:54
In reply to another Lamictal question, posted by bissie66 on July 30, 2003, at 18:32:20
Hi
Did you ever get your question answered? I'm not an expert on Lam. so I can't help you.
I experience similar mood swings as you - all within one day - high to low. Maybe it's actually elevated type with irritability so it can take on different faces throughout the day. It's so confusing to figure out - no distinct periods of time when it's elevated without being mixed with the downs. The depression has always been there for me underlying everything. I guess I answered my own question. I sound like I experience mixed states.
Katia> thanks everyone. so glad for this board. so many smart, well-informed posters.
>
> i have been on lamictal 5 days. i am taking 50 mg. once a day for 2 weeks, then 50 mg. twice a day for 2 weeks, then I see my pdoc.
>
> my question is this: should i split my 50 mg. into two doses of 25 mg. each? (i can cut the tablets). it seems that's how it's most often done, and i have noticed that by late afternoon/evening my moods are way up and down. granted, i am going thru a hard time, but in one hour i go from feeling very positive, hopeful, and grateful to hopeless and crying. these swings continue through the late afternoon, evening, and night. the moods change several times an hour. could just be what i'm going through in my life situation though. any input would be helpful. thank you.
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