Lamictal

[Wynn Wilder]

My doctor prescribed Lamictal for me, thankfully.

My other medications were failing, drastically. Sleeping was my best friend and that fact bothered me tremendously!!! My doctor recommended Lamictal to help regulate my sleep pattern and encrease my energy.

Now, at first I was hesitant. See, I'm one of these people who absolutely HATE taking medications. I have learned over the years that if I don't take them..... I'm not a nice person and it affects my children horribly. Something I can't live with, they shouldn't have to be "traumatized" by mom's erratic behavior.

Anyway, my Lamictal affects me "funny", at times. I take 75 mg's in the morning and sometimes it makes me a bit loopy and tired. Wait, I'm not sure about tired, although the best answer for the loopy side is to lay down.

I've discussed it with my doctor on numerous occassions. (I absolutely adore my doctor!! She answers every question I have and does it with a smile, while telling me that if I have any more questions to call her, any time! Always, ALWAYS have a doctor you can talk to!!!) Anyway, we can not figure out why it affects me sometimes but not others.

My theory is that I take my night meds to close to my morning meds. Unfortunately I have not tested this theory yet. I tend to work late and then forget when I get up to write down what time I took the morning meds and the evening meds. (It's a blonde things)

We haven't changed the dosage because it isn't a henderance, it's just a tad bit annoying. It makes my eye's a bit fuzzy at the worst but it passes. I will live with the "tad bit" of annoyance just to remain grouch free and sleep free. I rather like living a "normal" life.

But... I was wondering if there could be any other possible answer as to why my meds affect me sometimes and not others?

 

[David Baxter PhD]

It would be well worth keeping a notebook in a handy place and recording when this happens - date and time - before or after a meal - what you ate - etc. Since these medications do alter neurochemistry (they are supposed to - that's how they work) and since there are close links between the neurotransmitters and the endocrine system (hormones), when it occurs in your cycle could also conceivably be relevant.

Lamictal (Lamotrigine) is usually pretty well tolerated - two good sources for medication information are Dr. Koop and RxList - The Internet Drug Index for prescription drug information, interactions, and side effects, where you will find probably more information than you need. A caution: if you've never looked at medication literature, this sort of data can be alarming at first - bear in mind that the literature will list every possible side effect, no matter how unlikely, and that in order to judge the true risk you must look at incidence not only in the drug group but also in the placebo group. For example, if 12% of the "drug" subjects report drowsiness and 11% of the placebo subjects report drowsiness, it's probably NOT a significant side effect. Another thing you will note is apparently contradictory side-effects for a drug - for example, 12% of the drug subjects report increased sleepiness and 13% report insomnia - to me, this attests to the fact that individuals may react differently to a medication.

Brand Name: LAMICTAL
Generic Name: LAMOTRIGINE

· Most people who take LAMICTAL tolerate it well. Common side effects with LAMICTAL include dizziness, headache, blurred or double vision, lack of coordination, sleepiness, nausea, vomiting, insomnia, and rash. LAMICTAL may cause other side effects not listed in this leaflet. If you develop any side effects or symptoms you are concerned about or need more information, call your doctor.

· Although most patients who develop rash while receiving LAMICTAL have mild to moderate symptoms, some individuals may develop a serious skin reaction that requires hospitalization. Rarely, deaths have been reported. These serious skin reactions are most likely to happen within the first 8 weeks of treatment with LAMICTAL. Serious skin reactions occur more often in children than in adults.

· Rashes may be more likely to occur if you: (1) take LAMICTAL in combination with valproate [DEPAKENE® (valproic acid) or DEPAKOTE® (divalproex sodium)], (2) take a higher starting dose of LAMICTAL than your doctor prescribed, or (3) increase your dose of LAMICTAL faster than prescribed.

· It is not possible to predict whether a mild rash will develop into a more serious reaction.

Therefore, if you experience a skin rash, hives, fever, swollen lymph glands, painful sores in the mouth or around the eyes, or swelling of lips or tongue, tell a doctor immediately, since these symptoms may be the first signs of a serious reaction. A doctor should evaluate your condition and decide if you should continue taking LAMICTAL.

You can also access information about possible medication interactions - again, bear in mind that some of those listed are probably statistically rare:

From the DrKoop.com site, this link will list ALL known interactions with lamotrigine.

All Interactions for lamotrigine Results 1 - 15 of 594
The following drugs are known to interact with "lamotrigine". Please click on a drug name to check the interaction details. A red icon denotes a possible severe interaction, a blue icon denotes a possible moderate interaction, and a green icon denotes a possible mild interaction.

Darvon, Darvon-N, Depacon, Depakene, Depakote, Depakote ER, Depakote Sprinkles, divalproex sodium, PP-Cap, propoxyphene, sodium oxybate, valproic acid, Xyrem, 40 Winks, Abilify...

Or, for a shorter list, use this link to input other medications you are taking and check for those specific interactions.

One final caution: if two or more of your medications are listed as having possible interactions, this does not necessarily mean you will be affected and you should not make any changes to your medications without checking with your physician first - discontinuing many medications suddenly can be dangerous.

 

[David Baxter PhD]

Lamotrigine is Effective, Well Tolerated Maintenance

Lamotrigine is Effective, Well Tolerated Maintenance Treatment for Bipolar Disorder
European Neuropsychopharmacology
09/18/2003
By Deanna M Green, PhD

Lamotrigine, an anticonvulsant, is a well tolerated treatment that prevents both manic and depressive mood episodes, and may be complementary to lithium in the maintenance treatment of bipolar I disorder.

Optimal benefits can be achieved in the management of bipolar disorder with early and long-term treatment. One standard treatment is the use of lithium therapy to control mood episodes. However, recent studies have also implicated a role for lamotrigine in the treatment of hypobipolar depression and in a refractory variant of bipolar disorder accompanied by rapid cycling.

Joseph R Calabrese at Case Western Reserve University School of Medicine, Cleveland, Ohio, United States, and colleagues evaluated the use of lamotrigine in the maintenance treatment of bipolar I disorder.

The prospective study included 1315 patients (average age 43) with bipolar I disorder who were randomized to receive lamotrigine monotherapy (50 to 00 mg/day), lithium (serum levels 0.8 to 1.1 mmol/L), or placebo for 18 months. Efficacy was assessed by time to additional intervention for any mood episode.

Overall, both lamotrigine and lithium significantly increased the time to intervention for any mood episode over that observed for placebo. Specifically, the average time to additional intervention was 28 weeks for lamotrigine, 26 weeks for lithium and 12 weeks for placebo.

Further analysis revealed that only lamotrigine effectively prevented the need for intervention of a depressive mood. In addition, both lamotrigine and lithium were effective against manic episodes, though lithium was significantly more effective than lamotrigine.

The adverse-event profile for lamotrigine was similar to that of placebo, while patients receiving lithium reported higher rates of diarrhea and tremor than those receiving lamotrigine. Furthermore, more lithium-treated patients discontinued due to adverse events.

The authors conclude that "lamotrigine is an effective and well-tolerated maintenance treatment for bipolar I disorder," and that lamotrigine and lithium have "potentially complementary mood stabilizing properties."

Eur Neuropsychopharmacol 2003;13:Suppl 2:57-66. "Latest maintenance data on lamotrigine in bipolar disorder"