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I have been taking 50mg Lamictal, 25mg morning, 25mg night.  Today, I went to my pdoc and he's increased me to 100mg, 50mg morning and 50mg night.  I thought he would take me up to 75mg first.  Anyone else jump like that?  Ive been on 50mg for a month now, if that matters.  This just seems like a big jump to me.

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I've seen several posts where people have talked about going from 150 to 200, but offhand I don't know about your Q, from 50 to 100. I'm sure you'll hear from folks who do know.

My doc is so ultra cautious. Way over-the-top conservative with the titration. I'm still doing 12.5 at a time (just went from 175 to 187.5 last night; got to change my signature, I guess). I do appreciate his caution, though at times it does try my patience!

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Guest luli2545

Not sure about 50 to 100 mg lamictal in one step. I've been on 50 for a while; last pdco visit I'd been on 50 for a week or so or maybe two - three weeks. She said to get up to 75  if I could. I was like, oh I'm ok at 50, can't I just stay at 50? She repeated get up to 75 if I couldl. (clearing of throat)

Because of some weirdnesses that seem to have lessened, I'm not as wary of going to 75 as I was when I saw her. But, I haven't done 75 yet. Because of being concerned about having spacey cognitiion, which cognition is just fine now. Because of having had muscle aches, which I'm ok with now, no aches. And, mostly, I had had periods of feeling like I was on an amphetamine. I'm not feeling speedy now. Jaw tenseness, mostly gone now...

So, I feel ok on 50 mg now. And I know I will go up to 75 as pdoc advised. but not today. Maybe next Friday when I know I can take it easy...and I'll add the additional 25 to my just before bedtime dose.

Your doc knows way more than I do. I guess one idea would be, and I'm no doc., to do as recommended and if you become uncomfortable, call Doc., and I myself would back down to my most recent dosage where I felt ok, where I felt stable.

Hoping you have good results, and as I was kindly advised on these boards, a close connection with doc. during this process would probably be very good....like checking in ...

Good luck to us!

Luli

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Seems like a lot of docs desperate to avoid lawsuits. I went up:

1 week at 50mg

1 week at 100mg

1 week at 150mg

2 days at 175mg (my choice, pdoc said straight to 200. Went nutso, so went straight up as below)

thereafter 200mg

Amazingly, I survived. And that with no warnings from the pdoc about side effects or any other crap.

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I believe the reason most doctors use slow rates is to minimize the incidence of a patient getting the rash. I'm pretty sure there is some clinical research on this; at the moment I can't find it. But even if the evidence is anecdotal, it is worthy of consideration.

Here's a passage from one doctor who found such a relationship in his practice:

...This medication can cause a serious skin rash. When we first started using it, about 1 person in 10 was getting a rash, which is a high frequency of an allergic reaction to a medication.

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Thanks you guys.  Now that I've seen what others are doing, I think my pdoc is taking a pretty conservative approach with this.  He kept me on 50mg for a month, and now Im at 100mg for a month, so that is pretty slow.  He's not using the starter pack, I guess he likes to do it his own way, which is fine by me.

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OK revlow, fair cop. There are risks associated with going up too fast, but I wonder if docs sometime err on the side of caution for litigation reasons rather than medical ones.

<{POST_SNAPBACK}>

Certainly that's always a Q with the health care system, especially nowadays. It's CYA all over the place; trying to get a straight answer from a doc at times seems as easy as trying to nail a blob of mercury.

But the bottom line (IMHO) is if indeed there is a statistically significant difference in frequency of developing The Rash, depending on titration schedule. If that's the case, why risk it?

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But the bottom line (IMHO) is if indeed there is a statistically significant difference in frequency of developing The Rash, depending on titration schedule. If that's the case, why risk it?

<{POST_SNAPBACK}>

Quite agree. There is a clear statistical risk (isn't 'clear statistics' an oxymoron?), but as with any risk, it's not a step function. So there's no one rate of titration below which the risk goes away. Nor is there a clear point where the risk becomes unacceptably high.

What I don't get is why docs feel the need to go safer than GSK's schedule. GSK has some pretty scary lawyers, I'm guessing, and if they feel Xmg per week increase is safe then who are we to argue? More so, given how picky this med is supposed to be.

Now, what happens if someone loses it and checks out while titrating up soooo slowly? Do the family sue the pdoc for not getting their relative up to a therapeutic dose fast enough?

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Now, what happens if someone loses it and checks out while titrating up soooo slowly? Do the family sue the pdoc for not getting their relative up to a therapeutic dose fast enough?

<{POST_SNAPBACK}>

Yes, I do understand that concern.
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