Lamictal D/C

[Cetkat]

So, I'm on my own here and would like some help figuring out the best way to do this.

I'm at 400mg of Lamictal. I went down to 300mg a the other day ago and added 900mg of Neurontin as a precaution. I got some medium nasty side-effects yesterday, but they were manageable. Mostly vision issues, foggy head, dizziness, numbness and tingling in my hands. Today has been much better. Fogginess again.. some confusion. Took some Xanax, Klonopin, and Nadolol (normal meds - but also helpful). Then I got a bit speedy, and took and extra Xanax/Nadolol. Now I'm pretty much good. Slight confusion, but very minor and ultimately feeling pretty good.

I tend to react to med changes fairly well.

So my question is.. even though I'm feeling alright now.. how long should I wait to drop down another 100mg to 200mg Lamictal? Normally I'd just use my side-effects, or lack there of to guide me.. but Lamictal can cause seizures if taken off of too quickly.

I don't have a pdoc right now to advise me.. otherwise I wouldn't be asking.

So, basically.. how many days should I stay at each dose after the side-effects have left to properly d/c from this med?

Well educated guesses are fine. Or even answers from your own pdoc should you be able to broach the subject.

Thanks.

(Oh, and for those not in the know, this is pdoc approved, I just couldn't afford the visit that would have covered these things. I'm going off my meds in order to move on to Emsam - not just stopping treatment.)

[domovoi]

i was on 350 mg and was instructed by pdoc to reduce by 50mg every 10 days until i got to 250mg then reduce by 50mg every week. that was some time ago. i'm on 200mg again now and will be going off again soon and will probably take the same approach. evidently i am in no hurry, i'm not sure if you're in a hurry but reducing by 100 right away seems a bit too drastic. if i were doing that, i would wait at least 10 days between each 100mg reduction and then would probably reduce the last 100 mg by 50 (i.e. 100->50->0 rather than go from 100 --> 0). but my pdoc always errs on the side of caution.

[Cetkat]

i'm not sure if you're in a hurry but reducing by 100 right away seems a bit too drastic. if i were doing that, i would wait at least 10 days between each 100mg reduction and then would probably reduce the last 100 mg by 50 (i.e. 100->50->0 rather than go from 100 --> 0). but my pdoc always errs on the side of caution.

Yeah, I have 100mg and 200mg pills and went up from 300mg straight to 400mg going up.. so that's why. Perhaps I'll go 300mg -> 250mg -> 200mg?

[AirMarshall]

It varies, but on average it takes 7 days for blood levels to reach steady state after Lamictal changes.

[domovoi]

i'm not sure if you're in a hurry but reducing by 100 right away seems a bit too drastic. if i were doing that, i would wait at least 10 days between each 100mg reduction and then would probably reduce the last 100 mg by 50 (i.e. 100->50->0 rather than go from 100 --> 0). but my pdoc always errs on the side of caution.

Yeah, I have 100mg and 200mg pills and went up from 300mg straight to 400mg going up.. so that's why. Perhaps I'll go 300mg -> 250mg -> 200mg?

i would say so, but i also agree with what dianthus said.

[notfred]

The titration is the same as when you first titrated Lamictal, just do it in reverse.

nf

[Cetkat]

You might do fine with 100mg at the beginning. It just really depends. My doc had me split doses as needed, which helped. So you could do 300 ---->200 and if you're not digging the 200 just take another 50mg as needed.

I think I'm going to do this. Then if I start to feel anything worrisome, I can take a 50.

Thanks all!

[AnneMarie]

You might do fine with 100mg at the beginning. It just really depends. My doc had me split doses as needed, which helped. So you could do 300 ---->200 and if you're not digging the 200 just take another 50mg as needed.

I think I'm going to do this. Then if I start to feel anything worrisome, I can take a 50.

Thanks all!

I think the prescribing info sheet recommends this with 10 days to 2 weeks in between reductions. Personally, I'd go by 50mg and then 25mg the last 50mg, but I'm a wuss.

[Cetkat]

I think the prescribing info sheet recommends this with 10 days to 2 weeks in between reductions. Personally, I'd go by 50mg and then 25mg the last 50mg, but I'm a wuss.

Oooh.. good to know! I've successfully managed to get down to 200mg straight from 300mg. I think I'm going to try the same method of testing out a 100mg drop down to 100mg when the time comes, then 50mg, then 25mg - even if only for a few days.

Edit: I actually may end up just sucking it up and waiting for an opening at a pdoc up here rather than pay out the ass to go back to the one in the other city where I could get on Emsam more quickly. That's starting to make more sense. I'll still d/c the same way (in case I can get an appt soonish).. but waiting a couple more weeks without meds if I have to sounds doable. More of a wash-out can't hurt - especially with everything I was on. I can tell I'm more unstable. Sleeping more, more emotionally over the place, reactive more, but not necessarily having lower lows. Suppose that's to be expected - even if I have made an idiot of myself. But live and learn. I think overall, the process has gone well.

[tamagotchi]

The titration is the same as when you first titrated Lamictal, just do it in reverse.

When I titrated Lamictal, I had to go up in 12.5 increments until I hit 200, then I went from 200 to 250 (it felt like such a big jump!). Much of the time I went two weeks between increases because of side effects. All in all, it took six months to get to 250.

So, now that I'm facing a Lamictal taper in my near future, I really hope I can do it at some kind of "normal" pace and just endure the side effects... instead of the six months it took me to titrate...

[Cetkat]

The titration is the same as when you first titrated Lamictal, just do it in reverse.

When I titrated Lamictal, I had to go up in 12.5 increments until I hit 200, then I went from 200 to 250 (it felt like such a big jump!). Much of the time I went two weeks between increases because of side effects. All in all, it took six months to get to 250.

So, now that I'm facing a Lamictal taper in my near future, I really hope I can do it at some kind of "normal" pace and just endure the side effects... instead of the six months it took me to titrate...

I think you could. I have gotten some anxiety and stuff.. but not nearly the same as when I went on. The side-effects have been *much* more manageable. All that activation I had going on it is what made it so hard for me.

[Cetkat]

Well, I. Am. Off.

Phew..

Not a bad ordeal at all. Thought I'd still be on it, but after forgetting meds and not feeling too bad, I went down to 100mg early. Then, after not feeling much of a difference, went to 50mg - felt no more withdrawal and realized that I could probably stop taking it all together. So I did. This is the second day without and all I'm feeling is some remaining anxiety and very slight dizziness.

I must say I'm relieved. Before when I'd forget my meds, the Lamictal would make me all zappy, nauseous, dizzy, and numb/tingly. Big time. No zaps at all coming off thou and only slight nausea.

Now I'm only on Strattera (not going off), Saphris (going to be going off, but will probably wait a bit because it helps me sleep and I had originally planned the Lamictal to take longer), and my Thyroid med.

I'm a proponent of polypharmacy, but I must say that it's good to be off all of that. Quite excessive. Needed to be tried, but no more. My stance has always been that I'll do whatever it takes to have it work, but the fewer the better.

Anyway. Thank you all. I really appreciate the help and feedback.