lamictal double dosage

[mOoOdymama]

i think (not sure...) i took a double dosage of my lamictal 200 mg yesterday morning. not positive. but when i felt great last night and like i could roll anything off my back, i felt i must have taken double dosage. i hate when this happens. need to put the med in my pill box thingy so this doesn't happen. lamictal is too powerful to mess w/ like that. i felt good though which leads me to believe that this med CAN help me. it helped at 50 mg and then seemed alright til a few months ago...which is my 200 mg mark. so now i'm wondering if i should go up. thing is, neither of the people who've Rx'd this for me feel i can nurse & take a higher dosage of lamictal. this really upsets me...cuz i know other mamas here are nursing while taking these kinds of meds. sigh. so frustrating! they want me to wean my 1.5yo son. i'm heartbroken. he will be too if i have to wean him.

hmmm.

[mika]

You will be fine

I don't think you should increase. Usually, the highest one with a mood disorder should be at is a dosage of around 200mg. At a higher dose it won't really do the job for a mood disorder.

I take a higher dose because I have epilepsy. So it works for seizures at a high dose.

My recommendation and probably you pdoc's is to stay at 200mg.

[AirMarshall]

Lamictal doesn't work overnite. It takes a week at a higher dosage to reach a steady blood level and often longer to take effect.

There is no reason a 1.5yo child must be breastfed.

You are exposing him to possible injury from psychiatric meds without any potential benefit.

Continue to do the right thing by weaning your son so he isn't exposed to unnecessary meds, and then your doctor can adjust your meds to make you feel better.

You've done a wonderful thing by nursing him. Weaning is one of many passages in his life. Move on and enjoy the changes to come.

Best wishes, a.m.

[SashaSue]

If I understood your post correctly, the lamictal was working better, or at any rate, you were feeling better, at lower dosages. So why not go back to a lower dose?

I think I've read that the most common ages for weaning are around 6-8 months, or later on, around 2ish. So I'm kind of assuming you're planning on making the transition sometime vaguely soonish? If so, can you maybe just power through with the meds you're on until you're no longer breast feeding, and then increase your dosage? If not, it might not be a terrible idea to start thinking about when, but more importantly how, you are going to wean him. And then ways for you and your son to have that kind of quiet, close time together without the breastfeeding. Maybe with a bit of a plan in place, it wouldn't seem like such a sad, daunting thing?

[mudpuppy]

As a partial aside (I have no opinion on what you should or shouldn't do), I stopped breastfeeding my son at 12 months.

I replaced our nursing sessions with snuggly reading sessions.

He's 5 now, and a voracious reader. I think much of his reading enjoyment comes from the positive associations.

Reading = calm, cozy, safe & snuggly.

Whenever you do decide to move beyond the breast, "reading-cuddles" is a great way to maintain the closeness.

[fuchsia groan]

Lamictal doesn't work overnite. It takes a week at a higher dosage to reach a steady blood level and often longer to take effect.

There is no reason a 1.5yo child must be breastfed.

You are exposing him to possible injury from psychiatric meds without any potential benefit.

Continue to do the right thing by weaning your son so he isn't exposed to unnecessary meds, and then your doctor can adjust your meds to make you feel better.

You've done a wonderful thing by nursing him. Weaning is one of many passages in his life. Move on and enjoy the changes to come.

Best wishes, a.m.

I strongly disagree.

I'm nursing my 2 yr old twins, and the meds in my sig are up to date. My pdoc consults with another pdoc who specializes in meds and breastfeeding, and we run everything by the pediatrician, who also checks her sources. The whole team gave us a green light. We do bloodwork every few months for the lithium, and everything is fine. All the doctors agree that the benefits of nursing my toddlers far outweigh any potential risks from the meds.

If you've never nursed a toddler, you can't possibly understand how enormously important it is to them, and how much easier it makes parenting. Not only is nursing a wonderful experience for mom and kidlet(s), it is an instant CTRL-ALT-DEL for all the usual toddler insanity. And as such removes a lot of stress from mom's life - very important when you're coping with MI. The oxytocin boost while nursing is also calming.

It's very important to do your homework about the potential risks of medications, but many meds are low risk, and even more risky ones can be managed. A lot depends on how much of a drug gets into the milk, and how fast, and how quickly it leaves the milk. The risks are also lower if you're nursing a toddler - for one thing, because they usually get less milk than an infant and weigh so much more; and because you know your toddler much better than you can know a 3 wk old infant, so you have a much better sense of whether they're feeling off; and because toddlers (usually) don't nurse round the clock, so you have a long time window at night for drugs to enter and leave the milk.

So the risk/benefit ratio is about the opposite of what you wrote. The benefits of nursing are undeniable and immediate, and mom & toddler feel them every hour of the day. The risks of medication are often minimal. Of course, if the mom herself feels that a risk is unacceptable, end of story! But if a mom wants to continue nursing, that's often ok.

So. Ditto dianthus - get Hale's book. You can also read online. Here is a bundle of resources I put together for another site. LactMed is especially good. If the doctors tell you no, show them the data and ask why they disagree.

And all that said, if you can't find a pdoc who will educate him or herself about meds and breastfeeding and give you advice and options based on the evidence - if there is no possible way for you to get mental health treatment without weaning - then that would be the time to think about weaning. Believe me, I understand what a high priority nursing is, but if the ONLY way you can get treatment is to wean, you just might have to. Your kids need a healthy mom most of all.

[rowen]

The World Health Organization recommends breastfeeding until the age of two, for what it's worth. I think I read somewhere that the average age of weaning throughout the world is actually around four years - but don't quote me on that.

Will your prescriber agree to having kiddo's serum level tested every so often? That's what my pdoc intends to do once my kiddo vacates (which she needs to do. soon). For whatever reason, some people end up with more medication in their milk than others. Pdoc said that in his experience lamotrigine serum levels in breastfed infants (whose organs are a little more inefficient than toddlers) are low or sometimes zero.

[Duelist]

I weaned my son around 23 months due to a need to take antibiotics, I was aiming for 24 months, so this wasn't all that big of a deal, I would definitely NOT breastfed a child now with the current meds I take though, NO way in HELL. Anymore then I was want to get pregnant at this time. When I nursed I wasn't taking ANYTHING, nothing for pain, nothing for psyche meds, nothing. I know this isn't a breastfeeding topic per se' but I wanted to sound off to add my thoughts to the other posters.

At that stage we were only nursing three times a day and it was easily stopped so I could get rid of the infection I had. I hope your doctors are right about the situation fuschia groan, I would not risk my child's health regardless of having a dr approval with the kind of meds you're taking. But that's just me, playing things safer JIC. Sorry if I offended you but I felt it should be said.

I also agree that lamictal wouldn't affect you right away Moodymama, if you took a double dose. Not like Abilify or Risperdal or something atypical antipsychotic might or SSRI might.

[fuchsia groan]

I hope your doctors are right about the situation fuschia groan, I would not risk my child's health regardless of having a dr approval with the kind of meds you're taking. But that's just me, playing things safer JIC. Sorry if I offended you but I felt it should be said.

It goes without saying that everyone's comfort level is different. It's up to any mom to decide what she feels safe taking while nursing. Even if that means refusing to take things like Tylenol, which are not only safe while breastfeeding but safe to give directly to an infant. Who cares, it's her choice.

But let's not confuse comfort level with evidence. You can make all the melodramatic remarks you want about me "risking my child's health," but that doesn't change the facts. I've done my homework, and so have 3 MDs, including our pediatrician and a pdoc who specializes in meds and breastfeeding. And on the whole, I'm rather more inclined to trust the scientific evidence and the medical experts than somebody shaking a finger at me out on the internet.

I'll bet you a fancy coffee drink that my kids are at infinitely greater risk just riding in the car buckled into their carseats, eating dirt at the park, or running up and down the stairs than consuming a microgram or two of lamotrigine in my milk.

[Duelist]

I said I was sorry if I offended you, so I am not going to apologize again. I was stating my opinions which I feel strongly about, just as you do. I have strong opinions about having to take meds at all and I just said I hoped your dr's were right because I couldn't trust it studies or not.

I am of the mind you can't believe everything you read even if it's 'scientific evidence' because we can't know where the funding for 'studies' was generated from, there could be conflicts of interest we'd never know about. I can agree to disagree no problem, not trying to start a fight, so let's just agree to disagree and be done with it.

[fuchsia groan]

Fuschia, I think you've been doing a wonderful job with your kids, and have thought so since you started posting.

Aw, thank you!

Happy Duelist, no hard feelings. Tone doesn't always come across on the screen, you know?

[Duelist]

Fuschia, I think you've been doing a wonderful job with your kids, and have thought so since you started posting.

Aw, thank you!

Happy Duelist, no hard feelings. Tone doesn't always come across on the screen, you know?

Thanks fuchsia groan, I totally agree tone is impossible to convey on the internet. Thanks for understanding I meant no harm.

[Karin]

If it is ok to just talk about the Lamictal again?

I also just want to say that every time I titrated, it took 1 week to 10 days to get to the point where I stabilised and only then could I say: This is the effect of the higher dosage - am I good or not.

I also please just want to ask just for purely interest sake but don't want anyone to be angry but how long has Lamictal been available and has there any studies been done on Lamictal breast fed babies to be able to say they are OK or not and how do people know at what dosage a Lamictal breast fed baby will not be ok any more?

If it is ok to just talk about the Lamictal again?

I also just want to say that every time I titrated, it took 1 week to 10 days to get to the point where I stabilised and only then could I say: This is the effect of the higher dosage - am I good or not.

I also please just want to ask just for purely interest sake but don't want anyone to be angry but how long has Lamictal been available and has there any studies been done on Lamictal breast fed babies to be able to say they are OK or not and how do people know at what dosage a Lamictal breast fed baby will not be ok any more?