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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by qbsbrown on July 13, 2008, at 21:21:42
I've started Lamictal at 50mgs before with no problems. I just saw a new PDOC, and he wants me to follow the starter kit that has you at 25mgs for 2 weeks.
Is this the norm, or are people starting at 50mgs?
And im not taking any other meds that would affect it.
Brian
Posted by Phillipa on July 13, 2008, at 23:43:04
In reply to Lamictal starting dose usually 25 or 50mgs????????, posted by qbsbrown on July 13, 2008, at 21:21:42
Hi Brian yes the starter kits are the norm and start at 25mg for two weeks then 50mg for two weeks and then to l00mg . Some starter kits start at l2.5mg. Phillipa
Posted by SLS on July 14, 2008, at 5:03:40
In reply to Re: Lamictal starting dose usually 25 or 50mgs???????? » qbsbrown, posted by Phillipa on July 13, 2008, at 23:43:04
I would advise using the dosages and time periods to be found in the starter kit. Phillipa described it well.
The difference between 25mg and 50mg is a full 100% increase in dosage. While you might be able to get away with starting at 50mg, some people react to it with the precipitation of a rash, which can be dangerous. I would recommend not doing anything that would provoke a rash. If you do, you would have to start all over again and possibly start at 12.5 and move up more slowly.
- Scott
Posted by sunnydays on July 14, 2008, at 10:46:35
In reply to Lamictal starting dose usually 25 or 50mgs????????, posted by qbsbrown on July 13, 2008, at 21:21:42
My pdoc had me follow the starter kit. Supposed to reduce the risk of that rash that can happen. If you've started at 50mg before, I'm not sure why he'd have you start at 25mg, but that's what I did.
sunnydays
Posted by qbsbrown on July 14, 2008, at 10:54:09
In reply to Re: Lamictal starting dose usually 25 or 50mgs???????? » qbsbrown, posted by sunnydays on July 14, 2008, at 10:46:35
yeah, i've started at 50mgs a couple of times, with no sign of the rash. We're revisiting lamictal because i've never reached the therapeutic dose, but not because i couldn't tolerate it
thanks,
brian
Posted by blueboy on July 14, 2008, at 12:51:38
In reply to Lamictal starting dose usually 25 or 50mgs????????, posted by qbsbrown on July 13, 2008, at 21:21:42
> I've started Lamictal at 50mgs before with no problems. I just saw a new PDOC, and he wants me to follow the starter kit that has you at 25mgs for 2 weeks.
>
> Is this the norm, or are people starting at 50mgs?
>I'd start at 25mg for two weeks, for these reasons:
- Your chances of developing a rash are higher starting at 50mg. Apparently the current thinking is that starting out too quickly could cause a person to have to discontinue Lamictal, even though the person might have tolerated it at high dosage if it were titrated more slowly.
So, would you rather start slowly and be using it in six months, or start quickly and risk losing the possibility of taking it?
- Besides losing the ability to take Lamictal, the rash could conceivably (very rarely) be *nasty*, even fatal.
- If you tell your pdoc about it after the fact, he isn't going to trust you to follow prescriptions. Bad idea. You could lie to him, but that's an even worse idea.
Posted by qbsbrown on July 14, 2008, at 12:56:37
In reply to Re: Lamictal starting dose usually 25 or 50mgs????, posted by blueboy on July 14, 2008, at 12:51:38
I guess you're right, i'll go the long path. It just sucks to know that you have to struggle with/through what you are going through for another couple of months (although i've felt depression lift from 50mgs). But once i did race to get up too high, too quickly, and it ended up putting me in a mixed mood episodes for about a month.
So I'll chill out and deal with it.
Regards,
Brian
Posted by yxibow on July 15, 2008, at 2:28:06
In reply to Re: Lamictal starting dose usually 25 or 50mgs????, posted by qbsbrown on July 14, 2008, at 12:56:37
> I guess you're right, i'll go the long path. It just sucks to know that you have to struggle with/through what you are going through for another couple of months (although i've felt depression lift from 50mgs). But once i did race to get up too high, too quickly, and it ended up putting me in a mixed mood episodes for about a month.
>
> So I'll chill out and deal with it.
>
> Regards,
>
> BrianYes -- definately I would echo what has been said. My doctor was very conservative as are a lot of doctors of raising the dose. It goes up very slooooooowly until about 200mg before its proven you have no SJS rash potential. I imagine people who take much larger doses go on to raise a bit faster after that. Just a guess. That's how I did it anyhow.
-- tidings
Jay
This is the end of the thread.
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