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Re: What next? » alienatari

Posted by ed_uk on June 26, 2005, at 8:25:40

In reply to Re: What next?, posted by alienatari on June 26, 2005, at 2:47:50

Hi Chris,

>It discusses the interactions between lamictal and valproate.

See...........

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8823232&query_hl=10

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8885114&query_hl=15

Sounds more like an adverse effect of Lamictal than a drug interaction........

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9371937&query_hl=21

In order to reduce the risk of developing a rash, it's important to start Lamictal at a very low dose and to increase gradually. Patients on valproate need to be started on lower doses of Lamictal and titrated more gradually because valproate increases the blood level of Lamictal.

Does valproate increase the risk of the Lamictal rash? It certainly might do.........but I'm not conviced - provided that the initial Lamictal dose is very low and titration is very gradual.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8736144&query_hl=25

Lamictal + valproate can cause additive side effects such as tremor, sedation and incoordination........another reason to initiate Lamictal at a very low dose.

>"Pharmaceutical Benefits Scheme"

So it's a co-payment system - you pay a percentage?

>In Australia only people with Bipolar and Schizophrenia are entitled to this (though many psychiatrists will lie to get their patients the drugs for other reasons, however some wont and will force their patients to pay the full amount which is huge).

In the UK, all NHS prescriptions cost £6.50 unless you have an exemption - in which case you pay nothing. Exemptions include >60yrs, diabetes etc. No mental health conditions are exempt.

>Lithium

When you tried Li, what was your dose and plasma level? Did it help at all? I know you had lots of side effects, what were they?

>But then again, isnt the very definition of mania a form of psychosis?

You can have mania with or without psychotic features eg. hallucinations, delusions etc.

>So, yea. If I do go on Lamictal I really hope it goes on the PBS and I dont have to get it as a private script

Me too :-D

Love,
Ed xx


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