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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by sleepygirl on August 26, 2006, at 12:24:59
Hello,
I deal with a lot of anxiety and formerly depression. The anxiety is fairly in check at the moment (for me, that is ;-) I'm just not ruminating as much, a bit more...shall we say spontaneous? since I'm not tied up, preoccupied with the anxiety?
I'm taking 225mgs effexor XR each day and 25mgs of seroquel which knocks me out at night and quiets my head a bit.
The thing is my pdoc is talking about what med might be more appropriate instead of seroquel. The two he seems to be considering are lamictal and topamax. From my perusing of this board I know lamictal can cause a rash and topamax can have some cognitive slowing associated with it?
Anybody have some thoughts about either of these meds? or about anything? I'd greatly appreciate it.
Thanks,
sg
Posted by finelinebob on August 26, 2006, at 14:45:44
In reply to I'd love some input about mood stabilizers :-), posted by sleepygirl on August 26, 2006, at 12:24:59
... was very VERY hard to pronounce at first, and it's kinda funny to watch pharmacy clerks look at the label on the bag and watch their face screw up thinking, "Geez, that looks like a normal word, not like methyphenidate or some crazy doc stuff, but I still can't figure out how to say it".
Before I talk about the "issues" with Lamictal, I'd like to say
YMMV, and
that I've had no problems with it and lots of success. It was bad enough having "bipolar spectrum disorder", cycling between depression and anxiety or both or none. Toss on top of that severe PTSD. One moment I'd be in an incoherent rage. Next moment, instantaneously, wilting despair. With Lamictal, the PTSD rollercoaster has stopped completely, and the depression/anxiety peaks (peaks?! only valleys for those) have leveled out considerably. They're still there, but Lamictal makes my AD and benzo that much more effective.
Now for the issues. Well, one BIG issue, and one not to be taken lightly.
Lamictal **can** cause rashes. Very very bad rashes. In very rare cases, we're talking possibly scary bad, hospitalizing, life-threatening rashes. This is NO reason not to try this med, tho, if you are aware of what you are getting into, if you monitor yourself and enlist the aid of others if you need it (SigO, family, friends, Babble-onians, GP, T, PDoc, pets, etc.)
So, if you do start with it there are two things you need to do:
(1) follow the titration schedule religiously, to let your body get acclimated to the drug. When I started it, my PDoc gave me a "book" of pills in those punch-out bubbles (like a lot of OTC pills) and a rigid schedule (by day, not by the second or hour) on when to take what. Not that it was all that hard -- you started at one end, and kept punching out pills on the day they tell you to punch them out, until you get to the end of the book. Then you're ready for starting normal dosages.
(2) While you're working your way through the book, keep an eye out for rashes. Talk to your PDoc about them -- I think I remember reading that there are certain places in particular to keep an eye on. If you develop a small rash, talk to your PDoc about whether you need to see your GP. If you develop several or big rashes, make sure your PDoc tells you upfront what to do.
Quite frankly, I can't remember all the details because I've been on it for over a year and I never had an issue with it. Quite the contrary, it's been a blessing.
It may sound very scary, but that's because you need to treat this drug with respect when you are titrating up to therapeutic levels.
Some people get rashes and can live with it. Some get rashes and have to stop. But most people don't get rashes from it -- that's why PDocs continue to prescribe it, that's why the FDA hasn't taken it off the market, and that's why you won't hear from a couple hundred people on this thread saying "Lamictal never gave me any problems" ... we hardly ever hear enough about success stories. Again, YMMV.
But if you give it a shot, give it some respect (for the first month in particular) and you might find a better state of mind than you have right now.
flb
Posted by sleepygirl on August 26, 2006, at 18:36:29
In reply to Lamictal, for me... » sleepygirl, posted by finelinebob on August 26, 2006, at 14:45:44
MUCH appreciated fineline,
I shall let you know what happens...won't be for a while.
forgot to ask:
any weight gain issues with it?
thanks,
sg
Posted by finelinebob on August 26, 2006, at 18:50:43
In reply to Re: Lamictal, for me... » finelinebob, posted by sleepygirl on August 26, 2006, at 18:36:29
> any weight gain issues with it?
I think I'm about capped for my metabolism, and have been before I started it.
When I moved back to NYC and a new PDoc, when I was giving him a blow-by-blow account of my med history, the first thing he said as soon as the word "Zyprexa" left my mouth was "How much weight did you gain?" I didn't. SSRIs got me to where I am now, and I guess all the meds I've been on since have been at a maintenance dosage for my weight ;^).
But he didn't say anything of the sort when I said I switched to Lamictal.
Posted by Phillipa on August 26, 2006, at 20:37:41
In reply to Re: Lamictal, for me..., posted by finelinebob on August 26, 2006, at 18:50:43
Lamictal is a find med for boosting an ad if tx resistant is your problem. No it didn't make me anxious. I had the wierdest side effect at 50mg. Excess salivating so bad I had to keep opening the car door and splitting out. That was listed as an uncommon side effect. But I couldn't tolerate it it made me nausous. Oh and go to crazymed.org. I love his synopsis on the rash. He says you can go for days with it and if you should get it and it's very rare it's easy to get rid of stop the med. Love Phillipa
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