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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Christ_empowered on July 21, 2011, at 13:50:59
Hey. My new psychiatrist prescribed Lamictal. She said to start slowly so I don't get skin problems. The prescription just says 1 25mg tablet 2x daily. Can I start out at 50? She kind of has an accent, so I didn't catch some details she gave me.
Thanks.
Posted by Christ_empowered on July 21, 2011, at 13:52:22
In reply to How do I titrate Lamictal?, posted by Christ_empowered on July 21, 2011, at 13:50:59
She said the target dose for me is 200mgs/day. How long do you think it will take me to get to that point? Is that a reasonable dose? I know very little about Lamictal.
Posted by Zana on July 21, 2011, at 17:07:04
In reply to How do I titrate Lamictal?, posted by Christ_empowered on July 21, 2011, at 13:50:59
From what I know about Lamictal the answer is no. You need to start very slowly to minimize the risk of getting a serious rash- really serious. Go slow.
Posted by Phillipa on July 21, 2011, at 21:42:33
In reply to Re: How do I titrate Lamictal?, posted by Zana on July 21, 2011, at 17:07:04
CE late getting home but some now say start at 12.5mg a day. When I took it it came in a starter pack and started at 25mg a day for a week then I think 50mg. Didn't get above this as wierd saliva problem constant spitting so went off. 200mg is a reasonable dose. But Stevens Johnson's Syndrome can occurr with lamictal especially so go slow. I didn't know you had a new pdoc? What other changes are being made. Phillipa
Posted by floatingbridge on July 21, 2011, at 21:53:17
In reply to How do I titrate Lamictal?, posted by Christ_empowered on July 21, 2011, at 13:50:59
CE,
When I almost started lamictal once, it was made absolutely clear that a slow titration is imperative.
It is not an emergency medication and that is a treatment limitation because it cannot be used for immeadiate crisis management (as far as I know...). There are no 'heroic' measures with lamictal like in there are with some medication.
This sounds like you are stable, just not feeling well. Is this true? The positive news is that lamictal can really work once it's up and running. Please give it time.
> Hey. My new psychiatrist prescribed Lamictal. She said to start slowly so I don't get skin problems. The prescription just says 1 25mg tablet 2x daily. Can I start out at 50? She kind of has an accent, so I didn't catch some details she gave me.
>
> Thanks.
Posted by Christ_empowered on July 22, 2011, at 1:09:20
In reply to Re: How do I titrate Lamictal? » Christ_empowered, posted by floatingbridge on July 21, 2011, at 21:53:17
hey fb,
yeah, I think you gave an accurate assessment of my situation. I'm not psychotic, manic, or agitated; I just a) need a bit of a boost--I'm not able to think my way out of my melancholy and b) I want to prevent future episodes of severe depression.
I'll go slowly, I'm just wondering if the directions on the Rx have me taking too much too soon. I guess I need to do some googling.
Posted by jane d on July 22, 2011, at 8:49:42
In reply to Re: How do I titrate Lamictal?, posted by Christ_empowered on July 22, 2011, at 1:09:20
> hey fb,
>
> yeah, I think you gave an accurate assessment of my situation. I'm not psychotic, manic, or agitated; I just a) need a bit of a boost--I'm not able to think my way out of my melancholy and b) I want to prevent future episodes of severe depression.
>
> I'll go slowly, I'm just wondering if the directions on the Rx have me taking too much too soon. I guess I need to do some googling.Be alert to the dates on the information you find.
It's been years since I took lamictal and I'm afraid I don't remember what dose I started at. It could have been either 25 or 50. At the time there was a lot of talk about Stevens-Johnson syndrome. My recollection (admittedly very very hazy now) is that as time went by that became less of a concern as it became clear that most rashes were not that - just mild rashes that could be avoided by starting with a low dose and slowing down the rate of increase when they occured. And also that the recommended starting dose was reduced as a result. In short, don't rely on the older information which I'm sure is still floating around.
Of course since my recollections date from those same old days you probably shouldn't rely on them either.
Jane
Posted by floatingbridge on July 22, 2011, at 10:25:09
In reply to Re: How do I titrate Lamictal?, posted by Christ_empowered on July 22, 2011, at 1:09:20
Can you google the archives? And someone named PoodleDiva just asked about lamictal, but don't know if dose was discussed. And recently, I was told that that syndrome Jane D mentioned is an over rated risk, but just regular rashes can be a problem if the dose is pushed too fast. If I read Jane D right, her post backs what I was told about it about a year ago. I have two friends in real life on lamictal who are very med-sensitive, and they never had a complaint. They claim it's very helpful.
I am sorry for that melancholy. You will get it to remit. I know it will.
> hey fb,
>
> yeah, I think you gave an accurate assessment of my situation. I'm not psychotic, manic, or agitated; I just a) need a bit of a boost--I'm not able to think my way out of my melancholy and b) I want to prevent future episodes of severe depression.
>
> I'll go slowly, I'm just wondering if the directions on the Rx have me taking too much too soon. I guess I need to do some googling.
Posted by herpills on July 23, 2011, at 10:29:41
In reply to How do I titrate Lamictal?, posted by Christ_empowered on July 21, 2011, at 13:50:59
I remember with the old starter packs it was 25mg for 2 weeks, then 50 for 2 weeks, then 100mg. herpills
Posted by Christ_empowered on July 24, 2011, at 9:05:26
In reply to Re: How do I titrate Lamictal? » Christ_empowered, posted by herpills on July 23, 2011, at 10:29:41
cool. I have to order my pills online (not having insurance is AWESOME), so I'm buying 20 25mgs tablets, 20 50mgs tablets, 20 100mgs tablets, and then a whole lot of 200mgs tablets, which is my target dose. Is that a sufficiently slow titration you think?
Posted by floatingbridge on July 24, 2011, at 15:06:31
In reply to Re: How do I titrate Lamictal?, posted by Christ_empowered on July 24, 2011, at 9:05:26
> cool. I have to order my pills online (not having insurance is AWESOME), so I'm buying 20 25mgs tablets, 20 50mgs tablets, 20 100mgs tablets, and then a whole lot of 200mgs tablets, which is my target dose. Is that a sufficiently slow titration you think?
>
>CE, unless someone else weighs in here, everything *sounds cool* except for the jump from the 100 to the 200 dose.
Can you call that doctor back? It would be a darn waste of time if the titration started slow enough only to be complicated later. Just get her to talk slow and ask her to repeat. Write it down. Just my advice. I think it's o.k. To be a little careful getting those med instructions.
Anyone else do a slow titration of lamictal out there?
This is the end of the thread.
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