![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by storm on April 20, 2001, at 11:47:42
I was reading an article & it said that one in fifty to one in one-hundred patients will develop a potentially fatal rash. I was thinking about asking the dr for it but it seems so dangerous. is this drug new? and is tegretol as harmful?
Posted by JahL on April 20, 2001, at 12:15:32
In reply to lamictal, posted by storm on April 20, 2001, at 11:47:42
> > I was reading an article & it said that one in fifty to one in one-hundred patients will develop a potentially fatal rash. I was thinking about asking the dr for it but it seems so dangerous. is this drug new? and is tegretol as harmful?
Yes (the rather new) Lamotrigine carries the risk of a nasty rash, & tho' it's pretty rare, a search thru previous posts here will demonstrate it does occur.
The good news is that the chances of developing the rash are greatly reduced by slow & gradual upwards titration of the drug, avoiding sharp 'spikes' of dose increase, which are thought to precipitate the rash. Also VPA doubles Lamictal serum levels & necessitates an even more cautoius dosing regime.
If you do develop a rash (usually red & blotchy) then immediate discontinuation of the drug will usually quickly resolve the problem. So you can see that generally only reckless disregard for the drug will lead to a life-threatening situation.
I take 150mg & my only brush with the rash occured when I missed a dose, allowing blood levels to fall sufficiently such that the next dose caused a sharp increase. The rash faded after 12hrs.
Of the 2 (IMO) Lamictal may be the better choice for bipolar/unipolar depression; Tegretol tends to be more helpful in Temporal Lobe Epilepsy depression.
What other drugs have you tried?
Take care,
Jah.
Posted by JahL on April 20, 2001, at 12:26:43
In reply to Re: lamictal » storm, posted by JahL on April 20, 2001, at 12:15:32
> > > I was reading an article & it said that one in fifty to one in one-hundred patients will develop a potentially fatal rash. I was thinking about asking the dr for it but it seems so dangerous. is this drug new? and is tegretol as harmful?
I should also point out that of those unfortunate few who do develop the rash, a significant no. continue with Lamictal (obviously due to its benefits) w/o the rash progressing into anything more serious (ie Stevens-Johnson rash, an often fatal condition).
Posted by SalArmy4me on April 20, 2001, at 13:44:52
In reply to lamictal, posted by storm on April 20, 2001, at 11:47:42
Dear Storm,
Lamictal (lamotrigine) is an anticonvulsant now being used to combat bipolar disorder and major depression. But the fear of a rash has caused many to avoid the medication, and they now suffer with a drug that has more side-effects.
The fears over Lamictal (lamotrigine) rashes are unfounded. The chance of having a mild to moderate rash are 3%--according to clinical trials. But clinical trials done years ago do not necessarily predict the incidence of side-effects now. Besides, most of these rashes were due to taking a combination of Valproate and Lamictal, and they resolve without hospital stays. I believe that the chance of a seizure from Wellbutrin is much higher, and the chance of a hypertensive crisis with phenelzine is a little higher.
The chance of having a severe rash leading to hospitalization is reported as 0.3%. With those odds Storm, it is easier to get hit by lightening than it is to have a Lamictal rash. Point in case: You never hear in the paper about someone severely harmed
by Lamictal.
I have taken Lamictal for one year with a moderate benefit and no side-effects. I believe that Lamictal will replace Lithium as the drug of choice in bipolar disorder in 10 years, due to its prominent antidepressant effect and benign side-effect profile.
Posted by Jed00 on April 20, 2001, at 18:55:43
In reply to lamictal, posted by storm on April 20, 2001, at 11:47:42
It actually is not that dangerous. They have found out that the rash only occurs if you increase the dosage too quickly. So, it is not really a problem. I love this drug and it makes me feel so much better. Better than any other drug I've taken. My mood is great and I have lots of energy and I felt effects in one day. And the only side-effect I have is sometimes I have sleep problems because I have so much energy. But this is easily solvable.
I say, give it a try!
Posted by JahL on April 20, 2001, at 19:50:16
In reply to Re: lamictal » storm, posted by Jed00 on April 20, 2001, at 18:55:43
> > I love this drug and it makes me feel so much better. Better than any other drug I've taken. My mood is great and I have lots of energy and I felt effects in one day. And the only side-effect I have is sometimes I have sleep problems because I have so much energy. But this is easily solvable.
Wow. Good on ya.
Can you tell me yr dx, yr Lamictal dose & how long it was before you felt so good? I'm on 150mg.
(I agree with the sleep thing!)
Thanx,
Jah.
Posted by Jed00 on April 20, 2001, at 20:10:45
In reply to Re: lamictal » Jed00, posted by JahL on April 20, 2001, at 19:50:16
> Wow. Good on ya.Thank you!
> Can you tell me yr dx, yr Lamictal dose & how
long it was before you felt so good? I'm on 150mg.dx is bipolar. 50mg of Lamictal a day. I actually started feeling good the first day I started taking it which was back in October last year.
> (I agree with the sleep thing!)
I moved all 50mg day dose to the morning to try to help the sleep problem. But, I have to also take 1.5mg Ativan or more at night to help me sleep. I'm still working with my doc. on fixing the sleep problem permanently.
Posted by sar on April 21, 2001, at 3:01:55
In reply to Re: lamictal » JahL, posted by Jed00 on April 20, 2001, at 20:10:45
Jah,
I can't remember if you've mentioned this before or not, but does lamictal help w/ sp?
thanks & irie,
sar
Posted by JahL on April 21, 2001, at 15:27:09
In reply to Re: lamictal...jah, posted by sar on April 21, 2001, at 3:01:55
> > I can't remember if you've mentioned this before or not, but does lamictal help w/ sp?Hi sar.
Not sure I can answer just yet; equivocal results so far. To begin with, Lamictal reduced my s.p. markedly, however this remission has diminished with time, as have the other benefits.
I'm now approaching optimum dosage (150mg+) & hope the aforementioned benefits will reappear. I shld know within the month. If Lamictal does sort my depression, my guess is it will also eliminate the s.p.; my symptoms seem to be a part of a single syndrome; during the few, brief remissions I've enjoyed, all symptoms remitted simultaneously.
I'm about to add Gabapentin to the mix, primarily for its reputed anti-social phobia properties. At the very least I can expect the calming effect many report (some of which I cld do with). It may also augment the Lamictal.
I'll let you know how it goes.
J.
Posted by KarenB on April 21, 2001, at 18:12:20
In reply to lamictal, posted by storm on April 20, 2001, at 11:47:42
storm,
I was one of the few who got the rash. It only lasted less than two days at my titration to 75mg and was never really serious, so I continued and have definitely received benefit, with mood stabilization and in lifting my depressive symptoms.
Tegretol made me tired all the time.
Lamictal is worth trying if you have Bipolar disorder, especially with mixed states and/or rapid cycling.
Karen
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.