Posted by SLS on December 13, 2000, at 15:51:20
In reply to Re: lamictal, posted by Bob on December 13, 2000, at 9:34:01
Hi Bob.
> There is little doubt to me that the symptoms are drug related.I received a manufacturer's "kit" designed to keep track of the dose increases. It tells you to start right off with 2 X 25mg per day! It sounds like even this is too much to begin with.It is. Lamictal is approved only for partial epilepsy as an add-on to other anticonvulsants. As such, your Lamictal package reflects the suggested dosage guidelines when it is combined with these drugs. All of the older, major anticonvulsants, except for Depakote, speed-up the liver enzymes that are responsible for breaking down Lamictal. This accelerated rate must be accounted for when establishing dosage schedules. There is no official FDA approved use for Lamictal alone. Hence, when Lamictal is used for other unapproved "off-label" uses, the dosing schedule must be more gradual because enzymatic break-down is no longer accelerated. Being cautious, I prefer a titration rate that seems is generally accepted when using Lamictal alone.
For the sake of redundancy:
IMPORTANT! When taking Depakote (valproate), one MUST reduce these dosages by half.25mg - > 2 weeks
50mg - > 2 weeks
100mg - > 1 week50mg-300mg: Range for depression
200mg: Average for bipolar depression
300mg-600mg: Range for epilepsy
> It seems like the symptoms might be fading, so I guess I'll just hold at this dose for awhile, and then increase in 12.5mg increments. BTW, thank you for the therapeutic drug level info.> Did Lamictal end up helping you?
Yes. It provides me with a mild improvement. I suffer a very treatment-resistant bipolar depression. Therefore, that my response to Lamictal is at best minimal should not be construed as an example of its general effectiveness. It is a great drug and a fine choice.
> Did you ever experience itching or a rash?
Yes. Upon each dosage increase, my eyes itched in the corners. This usually disappeared within 48 hours.
I am happy to know that your reaction is subsiding. Even if a reaction were to occur for having been provoked by too rapid a titration, after withdrawal, one can successfully restart a more gradual schedule.
Bye the way, what is your current diagnosis?
- Scott
poster:SLS
thread:50461
URL: http://www.dr-bob.org/babble/20001130/msgs/50513.html