Fluffypinkbunny Posted May 20, 2015 Share Posted May 20, 2015 (edited) Just started yesterday at 25mg. Normally, how long do you stay at this dose, before going up? Also, how do you know what the correct/therapeutic dose will be? Didn't have a ton of time to go over this with pd yesterday. Sorry in advance if these questions are silly. Edited May 20, 2015 by Fluffypinkbunny Link to comment Share on other sites More sharing options...
tryp Posted May 20, 2015 Share Posted May 20, 2015 (edited) It depends - most times they won't go up faster than 25 mg/week because of the risk of SJS. When I started it, my doctor started me at 12.5 mg and I went up to 25 after a week, and then up by 25 mg every 1-2 weeks. My initial target dose was 100 mg which is considered the low end of therapeutic. Then I switched pdocs and my new one said she wanted me at 150-200 mg. I stayed at 200 mg for a while and then I got depressed again and went up. I stayed at 250 for years, now I'm trying to come off. Mostly I kept going up until it worked and then kept stepping up whenever it stopped working. Edited May 20, 2015 by tryp Link to comment Share on other sites More sharing options...
melissaw72 Posted May 20, 2015 Share Posted May 20, 2015 I stayed at 25 mg I think for about a week. It wasn't very long. The correct therapeutic dose, IMO, is the dose at which your symptoms are managed the best. Link to comment Share on other sites More sharing options...
jt07 Posted May 20, 2015 Share Posted May 20, 2015 (edited) Your pdoc should have told you how long you should stay at 25 mg or have it written on the med bottle. Or if you're lucky to get a starter pack, it should be all laid out for you. This is a vital question and requires medical expertise which we really cannot give over the internet. I think you should call your doctor's office and ask this question. As far as the therapeutic dose, it's going to depend on your diagnosis and how you react to the med. Usually, you want to stop at the minimum effective dose. I overshot my effective dose and was never able to find it again. Edited May 20, 2015 by jt07 Link to comment Share on other sites More sharing options...
Fluffypinkbunny Posted May 20, 2015 Author Share Posted May 20, 2015 Thank you all for your help! This was my last visit with this pd. My husband got a new job/insurance. Lucky for me, I'll now be seeing the best pd in the area. My first appointment is June 5th. No starter pack. They didn't have them at my pharmacy. Link to comment Share on other sites More sharing options...
jt07 Posted May 20, 2015 Share Posted May 20, 2015 Even if it was the last visit with your pdoc, could you still phone and ask for clarification? Because I'd hate to see you titrate too quickly only to be pulled off because of getting a rash, and on the other hand, I'd hate to see you sit at 25 mg for longer than necessary. If you can't get advice from your doctor, try calling the pharmacy. Link to comment Share on other sites More sharing options...
Fluffypinkbunny Posted May 20, 2015 Author Share Posted May 20, 2015 (edited) Thank you! I'll call tomorrow. Jt, would waiting two weeks to go up be bad? I don't mind going slowly. Edited May 20, 2015 by Fluffypinkbunny Link to comment Share on other sites More sharing options...
jt07 Posted May 20, 2015 Share Posted May 20, 2015 Going slowly is better than going too quickly, but I still think you should call. Link to comment Share on other sites More sharing options...
Fluffypinkbunny Posted May 20, 2015 Author Share Posted May 20, 2015 Calling is a nightmare. It's an outpatient clinic and they see tons of people. Much different then private pd. I'm so glad to be switching although the timing couldn't be worse, during med changes. Thank you for all your help! Link to comment Share on other sites More sharing options...
Wonderful.Cheese Posted May 20, 2015 Share Posted May 20, 2015 how long do you stay at this dose, before going up? I think 2 weeks I went to 50, then another 2 weeks to 100, then another 2 weeks, etc... But you really need to call your pdoc for instructions. Everyone is different and your meds may interact differently. Who knows. Also, how do you know what the correct/therapeutic dose will be? You will feel it. A lot of people hit the sweet spot around 200 mg. I take 300 mg. But I think my birth control causes it to lose its proper effectiveness by a bit. But some take 100 mg, and some take 600 mg even. It all depends on the person's response. I would also say that the ride up on lamictal (the titration) can be a bit rough. It is good to stick it out though. It will take a long time for it to work. Imagine if you need 200 mg it could take bare minimum 10-14 weeks. I know that sounds scary but it's worth it. It's a good med for lots of people. Just wanted to warn you to not get frustrated. And hell, maybe you will find it helpful at 100 mg even! Who knows! Good luck! Link to comment Share on other sites More sharing options...
Fluffypinkbunny Posted May 20, 2015 Author Share Posted May 20, 2015 Thank you Cheese for your help! I really hope this works for me. I've been on the med go round since December. Link to comment Share on other sites More sharing options...
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