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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Lyrical13 on January 17, 2004, at 7:00:30
I'm going to be starting on Lamictal next week for BP2 (to go along with the Effexor that I'm already on). My pdoc mentioned a rash as a side effect that we hope won't happen. I guess there is a rare complication from Lamictal that results in a permanent condition...Stephen JOhnson syndrome. ONe of the big components of it is a rash. So at the slightest sign of a rash we are going to d/c Lamictal. My question is, how common is a rash? Is it a side effect that goes away after a couple weeks? Any other side effects that I should know about?
I am hoping Lamictal will work for me b/c if it doesn't his next suggestion is Depakote. I don't know a lot about it but it seems like one of those meds that zombify you (like that word? I just made it up!)
Thanks for the info in advance
L13
Posted by girl1969 on January 17, 2004, at 9:51:37
In reply to Lamictal and rash, posted by Lyrical13 on January 17, 2004, at 7:00:30
L3,
I started on Lamictal about a month and a half ago. I was very reluctant to start it because of the rash. From what I've read, however, it's very rare. My pdoc has been prescribing lamitcal for years and he has never seen the "bad rash."
You can also get a much less serious rash, but it still has to be checked out. So far, I haven't had any rash at all.
The good news is, as long as you don't get the rash, there are incredibly few other side effects to deal with (for me, at any rate).
I was on Depakote for about 6 months. I started to feel emotionally numbed, not exactly like a zombie, but I didn't really react to anything or anyone (ok, maybe that is like a zombie?) It works wonders for some people, though, so your case may be different.
Wishing you the best of luck on Lamictal,
Girl
Posted by contemplative1 on January 17, 2004, at 10:23:25
In reply to Re: Lamictal and rash, posted by girl1969 on January 17, 2004, at 9:51:37
I take Lamictal and I got a minor rash, which was probably from combining it with Neurontin or who knows. But, the nasty potentially lethal rash is very rare and is most commonly caused by titrating too quickly up.
The common theory is that if you start at 25Mg and go up 12.5 or max 25Mgs per week you "should" be fine.
Posted by Emme on January 17, 2004, at 16:47:29
In reply to Lamictal and rash, posted by Lyrical13 on January 17, 2004, at 7:00:30
> My pdoc mentioned a rash as a side effect that we hope won't happen. I guess there is a rare complication from Lamictal that results in a permanent condition...Stephen JOhnson syndrome. ONe of the big components of it is a rash. So at the slightest sign of a rash we are going to d/c Lamictal.
> My question is, how common is a rash? Is it a side effect that goes away after a couple weeks? Any other side effects that I should know about?
I've seen reports that the incidence of rash is about 10 percent. The incidence of SJS is much less than 1 percent in adults. If you get a rash, head off to a dermatologist.
If your rash is mild and resolves easily, you can discuss with your doctor whether you want to retry Lamictal at a slower titration. It has been done and there are papers in the literature describing successful rechallenge with Lamictal. This is obviously a decision between you and your doctor of course.
Mild start-up side effects I had were feeling a little fluish for a couple of weeks and tight shoulder muscles for a couple of weeks - that all went away. Some headaches - that cleared up as well. It can be activating. Overall, it's great in terms of side effects.
Emme
Posted by HenryO on January 19, 2004, at 0:57:42
In reply to Re: Lamictal and rash, posted by girl1969 on January 17, 2004, at 9:51:37
No way are we talking ten percent. It would never be on the market. I don't know but it's way way less than 1 percent. That's why you start with a tiny dose to begin with. I'm a big Lamictal fan. I think when you reach a theraputic dose you will be happy with it. Weight neutral. No sexual side effects. Thats a good AD in my book. Hope you like it as much as I do. I'm on it over a year and a half now.
Posted by Flipsactown on January 19, 2004, at 5:51:52
In reply to Re: Lamictal and rash, posted by HenryO on January 19, 2004, at 0:57:42
HenryO,
I have been on lamictal, currently on 400mgs, for 4 months and was curious to know your current dosage and if you were taking it with other ADs. I am on prozac, remeron, lamictal and most recently lithium. I am still looking for the "magic bullet" AD that will sufficiently relieve my unipolar depression. Although the current combo is relieving my depression, they seem to poop out in the late afternoon so my pdoc added 300mg lithium 7 days ago. I have not been on lithium long enough to tell one way or another if it is indeed the "magic bullet". I also have not had any bad side effects from lamictal such as weight gain or sexual side effect. Eventually, I would like to be taking only lamictal and lithium. Your thoughts?
Flipsactown
No way are we talking ten percent. It would never be on the market. I don't know but it's way way less than 1 percent. That's why you start with a tiny dose to begin with. I'm a big Lamictal fan. I think when you reach a theraputic dose you will be happy with it. Weight neutral. No sexual side effects. Thats a good AD in my book. Hope you like it as much as I do. I'm on it over a year and a half now.
Posted by Emme on January 19, 2004, at 8:42:38
In reply to Re: Lamictal and rash, posted by HenryO on January 19, 2004, at 0:57:42
> No way are we talking ten percent.
Yes we are. I have researched it. The 10% is for *any* kind of rash.
> I don't know but it's way way less than 1 percent.
That is for Stephens Johnson Syndrom, a very very small subset of the total rashes that people get.
Emme
Posted by HenryO on January 19, 2004, at 19:35:17
In reply to Re: Lamictal and rash » HenryO, posted by Emme on January 19, 2004, at 8:42:38
OK, a rash but what are the stats on THE rash.
Posted by HenryO on January 19, 2004, at 19:48:48
In reply to Re: Lamictal and rash » HenryO, posted by Flipsactown on January 19, 2004, at 5:51:52
I am now only taking Lamictal 200mg and Klonopin 5-10mg. I have recently dropped Concerta. I still have bad days. But in general I'm pretty good, which is saying something.
I have taken some pretty serious cocktails over the years but never more than four meds at a time. When they start suggesting number five, I reassess the whole thing. There is just too much going on sometimes to know what is doing what.
That Klonopin really helped. But you have to move one piece of the puzzel at a time or you never know what did what. That's why those complex cocktails made me uneasy. I was on Resperdal Prozac Ritalin and Trazadone. I have tried in different combinations Welbutrin Effexor Nurontin (It killed my Libido) and many others I can't remember.
I have theory that long term Prozac use is a bad thing.
Keep searching.
Posted by Emme on January 19, 2004, at 21:43:31
In reply to Re: Lamictal and rash, posted by HenryO on January 19, 2004, at 19:35:17
> OK, a rash but what are the stats on THE rash.
>
>I can't recall exact numbers off hand. Certainly way less than a percent. But there's qualifiers. Incidence is different for youngsters vs. adults - it's not recommended for those under 16. Risk is higher if you're taking valproic acid because that increases blood concentrations of lamictal - dosages and titrations have to be adjusted accordingly. And, finally, rate of titration (valproic acid or no). Slower titration decreases risk of any rash and would, therefore, lower the risk of a dangerous rash. From what I can tell, pdocs have become more savvy about doing a slow titration.
Anyway, for *exact* stats, some online searching should turn up some info. Glaxo-Smith-Kline has the product info online, and there are other info soucrces as well. A couple of months back or so, I posted a list of a few places where I had found some info on Lamictal - I may or may not have put actual links. If you search on Psycho Babble it ought to show up. Anyway, if I get a free moment, I'll try to dig it up for you.
I certainly don't mean to diminish the high stakes of potentially developing SJS and utter severity of the illness. I can tell you that I'm one of the people who successfully increased Lamictal despite some minor rash problems. We proceeded with anxiety, caution, a dermatologist, and a glacially slow titration.
Posted by Emme on January 19, 2004, at 21:49:13
In reply to Re: Flipsactown, posted by HenryO on January 19, 2004, at 19:48:48
> I am now only taking Lamictal 200mg and Klonopin 5-10mg. I have recently dropped Concerta. I still have bad days. But in general I'm pretty good, which is saying something.
That's good. I keep hoping for Lamictal monotherapy, or Lamictal with clonazepam. The stuff helps, but I still seem to need AD augmentation. I have a sneaky feeling I may end up with a count of four, which is more than I'd like. But functioning is good too. :) I know what you mean about being unsure of what's doing what.
Posted by Lyrical13 on January 20, 2004, at 0:15:20
In reply to Re: Flipsactown » HenryO, posted by Emme on January 19, 2004, at 21:49:13
Posted by dragonfly25 on January 20, 2004, at 8:19:15
In reply to which med is valporic acid (brand name) please? (nm), posted by Lyrical13 on January 20, 2004, at 0:15:20
This is the end of the thread.
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