gballsout Posted February 21, 2014 Share Posted February 21, 2014 I take Lamictal (generic Lamotrigine) at 100 mgs per night. I started the Pill (microgestin) last fall to control heavy bleeding and cramps due to fibroids and shortly thereafter experienced a quick fall into depression (I have been well controlled after years). I was desperately suicidal and managed to somehow get the pdoc before harming myself. I had also done some research and found that Lamictal and Microgestin are counter-intuitive and asked him to look it up. Well, isn't it in the Big Book that the Pill cuts Lamotrigine intake in half! I was furious b/c I was so depressed I missed work and wasted time being depressed and was considering killing myself even though I told both my GYN and my P-doc all of the meds I was taking (esp concerned with moods on the Pill!) and neither of them nor the pharmacy caught it. So, I'm warning you if you choose or are on these meds. Link to comment Share on other sites More sharing options...
melissaw72 Posted February 21, 2014 Share Posted February 21, 2014 Birth control tends to lower the amount of lamictal in your blood, so you may need to increase it while on the pill. I had to do that when I was on the pill. Link to comment Share on other sites More sharing options...
tamagotchi Posted February 21, 2014 Share Posted February 21, 2014 Yes it's unfortunate that most pdocs don't seem to handle this interaction very well. The interaction is in the Lamictal PI sheet and it even has instructions about how to stop/start OCP while on Lamictal. However, pdocs don't always read PI sheets.... Gynecologists for the most part have no idea that there even are any drug interactions with OCPs. Actually OCPs interact with lots of meds. My pharmacist did catch it though, and called me when she got the initial OCP prescription from my gynecologist to discuss it with me before she filled it. For most people an estrogen-containing OCP cuts Lamictal in half, but everyone's body processes meds a little differently, so ideally you would take a blood level before you start the OCP, and then adjust the Lamictal and take blood levels weekly until you get it all evened out. Link to comment Share on other sites More sharing options...
gballsout Posted February 21, 2014 Author Share Posted February 21, 2014 I find it interesting that now that I am not bleeding at all (I'm taking the Pill in a way to stop my periods entirely), my med was cut in half at all. It seems like it should build up in my system rather than subtract. Thank you for your comments. I am taking more Lamictal now to make up for it but my BFF was furious as well and went as far as to say that all the docs involved were negligent and what if I had done myself harm? I think they were just clueless as Tamagotchi said. Link to comment Share on other sites More sharing options...
tamagotchi Posted February 21, 2014 Share Posted February 21, 2014 (edited) Med interactions frequently come about because one medication either speeds up or slows down the metabolism of another medication. Estrogen containing OCPs speed up the metabolism of Lamictal, so the level of Lamictal in your bloodstream decreases, and you have to take more Lamictal. As another example, Tegretol affects Lamictal to about the same extent as OCPs do (Tegretol interacts with a lot of meds). On the other hand, Depakote slows down the metabolism of Lamictal, doubling the amount of Lamictal in your system, so you take about half as much Lamictal. There are lots and lots of interactions like this between meds. Doctors do sometimes fail to check interactions before prescribing medication. But also, not all interactions show up in standard med interaction checkers, even though they may be well known in the literature and even appear in the PI sheet like this one. So, doctors are not always to be blamed for this. If you take several meds it's a good idea to do your own research as best you can, I've discovered things myself that my pdoc wasn't aware of. Edited February 21, 2014 by tamagotchi Link to comment Share on other sites More sharing options...
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