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Old 12-02-2009, 01:14 AM   #1
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Doc uping Lamictal to 300mg

My pdoc is upping my Lamictal to 300mg...when I was in his office he opened his PDR to look at dosing and he said the "theraputic dose is 200mg but he knows he has patients on higher doses"....so he went out to get another patient's chart in the hallway to confirm (I'm assuming) the mg's that another patient is taking. I said to him, "I'm concerned I will hit a ceiling with the med or it will no longer work"...he said, "then we would just add another med" which, of course, I'd hate to do. But he said compared to what I was taking years ago (approx 10 plus different psych meds) this was nothing (on other meds not psych related too). But he says it's working well but could be working better, so he wants to up the dose. I still ultra rapid cycle, get into Major depression, experience pysychosis, have mixed episodes yada, yada, yada on meds, they just seem to be taken down a knotch with them where I don't completely lose touch with reality.

Well what dose are you on? Anyone at 300mg's? Is there much adjustment from going from 250mgs to 300mg's? Any insight, opinions, thoughts would be greatly appreciated!

tattoos

 
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Old 12-02-2009, 01:32 AM   #2
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Re: Doc uping Lamictal to 300mg

This is a very relevent question for me. I just had an Inpatient stay with two purposes, getting my Insomnia under control and also getting the Lamictal dose higher and quicker, which the Doc wouldn't do unless I was in hospital. We achieved getting me to 200mg Lamictal, which I am on now. I haven't experienced any positive change yet, but I was only on that 200mg dose since Monday and it is now Wednesday. But my understanding is that I will continue to go higher, maybe to 300mg - the upward progress will just be slower now that I am at home. The main reason why my doctor is so conservative in upping my Lamictal is because of the terrible nature of the rash which only a tiny percentage of people get.

I have scoped around the various Bipolar Blog sites and asked Bipolar people about their experience with Lamictal. I have read overwhelmingly glowing reports about it, except one woman who did experience the rash and if that happens people have to go off Lamictal immediately and they can't go back on it.

Maybe for both of us, we need to wait a while until the drug can kick in at the relevant dose. I don't rreally know what timeline to expect - I asked my psych and he couldn't give me a timeline, so I'll have to be patient - and I don't feel patient!?!

 
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Old 12-02-2009, 09:19 AM   #3
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Re: Doc uping Lamictal to 300mg

Do you take birth control pills? According to my pdoc, that cuts the effective dose in half, so if you take 300mg. you're really only getting 150 mg.

I'm at 200mg (100mg effective dose), but everytime I'm start a major depressive episode we up it 50mg. I'm terrified that when I get to 400mg, I'll be out of options. Since I get one nearly every year (not one this year, by some miracle) I'm really scared about what happens in 5 years.

 
Old 12-02-2009, 05:20 PM   #4
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Re: Doc uping Lamictal to 300mg

Bethann, I didn't know about the effect of the Pill on Lamictal that you mentioned. I'm not sexually active, but I am on the Pill as since I was 11 years old when my period started, right up to now when I am 43 tomorrow, I have had terrible depression in the two weeks leading to my period. Over the years as the Bipolar symptoms have gotten worse, and because I was also mis-prescribed for a long time, the PMT has mean I have literally been suicidal in those two weeks, even when my mental health was reasonable.

So these days taking the pill is part of my whole mental health plan. But I WILL ask my psychiatrist about it. Thank you.

 
Old 12-03-2009, 02:26 PM   #5
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Re: Doc uping Lamictal to 300mg

It's not that you can't take the pill with lamictal, or that it's dangerous or anything, it's that your lamictal dose may be too low if your doctor isn't adjusting it to take the pill into account. I don't know if this is true for progesterin only pills, so it might be a good idea to take your pill packet with chemical ingredients in with you to your appointment.

 
Old 12-03-2009, 03:35 PM   #6
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Re: Doc uping Lamictal to 300mg

I read that lamictal regulates sodium levels. Do you crave salt at all?

Salt craving can be a sign of adrenal gland insufficiency?

I have low blood pressure, and have to ensure adequate salt intake, together with a good diet.

Also, there is a link between the pill affecting the zinc/copper balance of the body.

I was on the pill, and had a zinc deficincy (excess copper), which has been corrected by supplementation of zinc. This was from hair analysis, which also showed I had extremely high levels or arsenic- it was off the chart.

hope this helps

 
Old 12-03-2009, 05:29 PM   #7
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tattoogirl HB User
Re: Doc uping Lamictal to 300mg

Quote:
Originally Posted by Wendy489 View Post
This is a very relevent question for me. I just had an Inpatient stay with two purposes, getting my Insomnia under control and also getting the Lamictal dose higher and quicker, which the Doc wouldn't do unless I was in hospital. We achieved getting me to 200mg Lamictal, which I am on now. I haven't experienced any positive change yet, but I was only on that 200mg dose since Monday and it is now Wednesday. But my understanding is that I will continue to go higher, maybe to 300mg - the upward progress will just be slower now that I am at home. The main reason why my doctor is so conservative in upping my Lamictal is because of the terrible nature of the rash which only a tiny percentage of people get.

I have scoped around the various Bipolar Blog sites and asked Bipolar people about their experience with Lamictal. I have read overwhelmingly glowing reports about it, except one woman who did experience the rash and if that happens people have to go off Lamictal immediately and they can't go back on it.

Maybe for both of us, we need to wait a while until the drug can kick in at the relevant dose. I don't rreally know what timeline to expect - I asked my psych and he couldn't give me a timeline, so I'll have to be patient - and I don't feel patient!?!
Hi Wendy...welcome home from inpatient! I'm not sure when you take your Lamictal but I found taking it at night affected my sleep (kept me up) but actually my sleep is ALWAYS interupted...recently didn't sleep for 4 days (not due to hypomania) and I wake up virtually every hour, every night otherwise. I have found that Lamictal had been the best mood stabilizer for me so far (been on at least 15 plus meds over time). I find I still experience all my Bp symptoms, even psychosis, but for the most part it helps keep me from going completely off the deep end. Part of the reason he is upping my dose. I am also worried about the rash issue (my sister had it) and given it can happen anytime worries me, especially since Lamictal has been quite tolerable for me.

I think it took about 3 months to really notice a difference. But sometimes I just don't know, especially because I still have major symptoms. I think it just keeps me out of a straight jacket.

~tattoos

 
Old 12-03-2009, 05:30 PM   #8
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Re: Doc uping Lamictal to 300mg

Bethann, thanks for the info on the BCP affecting Lamictal, I had no idea. I am on BCP and will have to be forever due to PCOS.

 
Old 12-03-2009, 10:15 PM   #9
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Re: Doc uping Lamictal to 300mg

Tattoos, thank you for telling my it took a few months for the Lamictal to kick in for you. This information just means I am not looking for immediate results and thinking it's all been a failure if I don't experience change soon. I am generally suicidal most of the time so if I am of the understanding that something should be kicking in early and it's not - well that makes me think things are hopeless. And I'm simply not prepared to live this way forever.

 
Old 12-04-2009, 09:19 AM   #10
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Re: Doc uping Lamictal to 300mg

I don't remember how long it took for lamictal to be effective, but I do know it was more than 2 months--then it turned into a wonder drug. I too may have had sleep issues taking it at night (hard to say since we were still working on getting my chronic insomnia under control) so I take it in the am.

My pdoc and all the research I did said that the rash only happens as you're going on it, and that with the switch to such a slow buildup it's been virtually eliminated. So I wouldn't worry too much if you're already on it.

 
Old 12-05-2009, 12:38 AM   #11
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Re: Doc uping Lamictal to 300mg

Quote:
Originally Posted by Wendy489 View Post
Tattoos, thank you for telling my it took a few months for the Lamictal to kick in for you. This information just means I am not looking for immediate results and thinking it's all been a failure if I don't experience change soon. I am generally suicidal most of the time so if I am of the understanding that something should be kicking in early and it's not - well that makes me think things are hopeless. And I'm simply not prepared to live this way forever.
Hi Wendy, one of the reasons we are upping my Lamictal is the continual suicidal thoughts (along with a myriad of other issues). The med has helped lessen the SEVERE, gut wrenching, all consuming suicidal thoughts.... something might push me over the edge at any second kinda of thoughts...to intrusive, upsetting but manageable. Don't give up, it will take time, I have been on loads of other meds, with no or VERY little "success" and I believe you have as well, and I have a good feeling Lamictal might be helpful to you (after reading your posts and finding quite a few similarities in our circumstances). Of course there will still be ups and downs, and adjustments made but all around I think it's a "great" med for Bp.

Let me know how things are going for you and hang in there girl!

~tattoos

 
Old 12-05-2009, 12:42 AM   #12
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Re: Doc uping Lamictal to 300mg

Quote:
Originally Posted by Bethann01 View Post
I don't remember how long it took for lamictal to be effective, but I do know it was more than 2 months--then it turned into a wonder drug. I too may have had sleep issues taking it at night (hard to say since we were still working on getting my chronic insomnia under control) so I take it in the am.

My pdoc and all the research I did said that the rash only happens as you're going on it, and that with the switch to such a slow buildup it's been virtually eliminated. So I wouldn't worry too much if you're already on it.
My sister actually got the rash at about 1 to 1 1/2 yrs into treatment!!! Not as common though. It can happen at any time but most likely in the beginning or when upping the dose. I believe she was upping her dose another 50mg at the time.

Thanks!

 
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