cloudmonger Posted December 18, 2016 Share Posted December 18, 2016 I've had the strange feeling that my Lamictal seems to "wear off" by evening...However, I read that the half-life is 29 hours (i always take around 9am every morning). I don't know if it's a sign that my dose is not high enough? Or maybe splitting the dose (morning/night) would be better? I hate to take meds twice per day. I seem to be pretty good morning/daytime and then once it's dark, I get increasingly moody and get pulled down, feeling more depressed. Link to comment Share on other sites More sharing options...
melissaw72 Posted December 18, 2016 Share Posted December 18, 2016 5 hours ago, cloudmonger said: I've had the strange feeling that my Lamictal seems to "wear off" by evening...However, I read that the half-life is 29 hours (i always take around 9am every morning). I don't know if it's a sign that my dose is not high enough? Or maybe splitting the dose (morning/night) would be better? I hate to take meds twice per day. I seem to be pretty good morning/daytime and then once it's dark, I get increasingly moody and get pulled down, feeling more depressed. If it were me, I'd try splitting the dose. But if after a few days that doesn't seem to be working well, I'd ask pdoc if s/he could raise the dose to see if that would help. Link to comment Share on other sites More sharing options...
tryp Posted December 18, 2016 Share Posted December 18, 2016 Mine definitely wears off in the evening if I take it once a day. I have to take it in divided doses and then I'm ok. Link to comment Share on other sites More sharing options...
browri Posted December 22, 2016 Share Posted December 22, 2016 I take mine twice a day as well. 200mg total. I did that because I was taking it all at night and I would wake up on a foggy daze some mornings and couldn't really fully get going. Lamictal can also be stimulating and it was interfering with my sleep a bit. I found that splitting it made me feel more consistent and also helped to deal with some of the side effects. It's worth it. Plus, even if the half-life is 29 hours, I've read that it can vary wildly. I've seen some half-life estimates being as low as 18 hours depending on the person. Link to comment Share on other sites More sharing options...
ByePolarCoordinates Posted January 3, 2017 Share Posted January 3, 2017 There is also an extended release version of it available that would allow you to still dose once a day and reap the benefit of a more consistent level. Link to comment Share on other sites More sharing options...
notloki Posted January 3, 2017 Share Posted January 3, 2017 My neurologist insists I split my dose for this very reason. Link to comment Share on other sites More sharing options...
cloudmonger Posted January 3, 2017 Author Share Posted January 3, 2017 (edited) Interesting. Very surprised to see so many people splitting the dosage morning/eve, my doc advised against this. I just switched from Generic 25mg (taking 4 pills at once to equal 100mg) to the Brand name Lamictal 100mg (1 pill dose). I know it's too early to tell, but the coverage seems to be more even lasting coverage...still not perfect so planning to try increased dose with pdoc soon. Edited January 3, 2017 by cloudmonger Link to comment Share on other sites More sharing options...
melissaw72 Posted January 3, 2017 Share Posted January 3, 2017 10 minutes ago, cloudmonger said: Very surprised to see so many people splitting the dosage morning/eve, my doc advised against this. Did your pdoc say why not to split the dose? Link to comment Share on other sites More sharing options...
cloudmonger Posted January 3, 2017 Author Share Posted January 3, 2017 3 minutes ago, melissaw72 said: Did your pdoc say why not to split the dose? I will ask again....he didn't say why, just when I asked if i should take morning or night or split the dose, she indicated always take all dosage at once, in the morning. Link to comment Share on other sites More sharing options...
melissaw72 Posted January 3, 2017 Share Posted January 3, 2017 2 minutes ago, cloudmonger said: I will ask again....he didn't say why, just when I asked if i should take morning or night or split the dose, she indicated always take all dosage at once, in the morning. I'm interested in hearing why she is against splitting the dose. Link to comment Share on other sites More sharing options...
CantEven Posted January 15, 2017 Share Posted January 15, 2017 I thought it was a drug that works over the long-haul like prozac, not wear out in a day like adderall? Maybe that's why I'm finding myself bawling right now.. I just take it all at once in the AM. I thought I was fine for a good week and felt good and now BAM: Here I am. Link to comment Share on other sites More sharing options...
CantEven Posted January 15, 2017 Share Posted January 15, 2017 Sure enough I have had a great day and felt great, and 5:30 rolls around and I'm thinking irrational thoughts like "I'm going to die alone, no one will come to my funeral, nothing matters anyway" as I sink into a hole. Or crying over trying to choose mouthwash at the store. Like that is not normal behavior, no idea wtf is wrong with me. I guess I'll just have to split the dose and see what happens. You know, just typing things out feels like relief. Whatever. Link to comment Share on other sites More sharing options...
Micho Posted January 16, 2017 Share Posted January 16, 2017 Hmmm I just take the 150mg pill in the morning in one dose. Wasn't aware of the splitting. Link to comment Share on other sites More sharing options...
cloudmonger Posted January 16, 2017 Author Share Posted January 16, 2017 (edited) 10 hours ago, CantEven said: Sure enough I have had a great day and felt great, and 5:30 rolls around and I'm thinking irrational thoughts like "I'm going to die alone, no one will come to my funeral, nothing matters anyway" as I sink into a hole. Or crying over trying to choose mouthwash at the store. Like that is not normal behavior, no idea wtf is wrong with me. I guess I'll just have to split the dose and see what happens. You know, just typing things out feels like relief. Whatever. I'm still having a bit of the same thing. My doc advised to up my dose - an extra 25mg for a week, then go up to 150mg. The target dose is 100mg-200mg (many people take more). So we shall see. I forgot to ask her about splitting the dose! I'll see what she says about that. With the long half-life of Lamictal....It makes me wonder if I'm one of those "Rapid Metabolisers" where my body metabolises it quicker than most?? I'm small - 5'4" and 107 pounds..so you would think that 100mg would be enough for my weight and provide full coverage. It just seems like the coverage is a bit iffy. I'm still curious - how many other people here have noticed this problem and fixed it by splitting the dose? I just hate to do that because it's more of a hassle, just another thing to worry about & remember every day. Edited January 16, 2017 by cloudmonger Link to comment Share on other sites More sharing options...
melissaw72 Posted January 16, 2017 Share Posted January 16, 2017 37 minutes ago, cloudmonger said: With the long half-life of Lamictal....It makes me wonder if I'm one of those "Rapid Metabolisers" where my body metabolises it quicker than most? I am a rapid metabolizer which is why I need higher doses to have some effect. I think that taking a higher dose (still all at once) will (I think) will still just wear off towards the end of the day too. I'm not DR ... but FWIW I don't understand why some DRs are against splitting the dose. If every DR agreed to not split the doses of meds, then I'd think that maybe taking it all at once would be the best idea. However I have never encountered a DR who is against splitting doses (until people talking about it on CB) ... and who actually wants to split the dose when the med/s don't seem to be helping me through the entire day. Link to comment Share on other sites More sharing options...
cloudmonger Posted January 16, 2017 Author Share Posted January 16, 2017 3 minutes ago, melissaw72 said: I am a rapid metabolizer which is why I need higher doses to have some effect. I think that taking a higher dose (still all at once) will (I think) will still just wear off towards the end of the day too. Do you know which is more of a factor in finding the right med dosage? A person's weight or the speed of metabolism? (i.e. if a person weighs 200 pounds versus 100 pounds, does this necessarily mean the heavier person will need to take twice the dose?) I'm not sure how it all works. I have no idea how "fast" my metabolism is, i just know i eat very healthy & exercise regularly in order to maintain my ongoing/slim weight (basically, I work at it, I can't just eat whatever I want or I will indeed gain like an average person). Link to comment Share on other sites More sharing options...
melissaw72 Posted January 16, 2017 Share Posted January 16, 2017 57 minutes ago, cloudmonger said: Do you know which is more of a factor in finding the right med dosage? A person's weight or the speed of metabolism? (i.e. if a person weighs 200 pounds versus 100 pounds, does this necessarily mean the heavier person will need to take twice the dose?) I'm not sure how it all works. I have no idea how "fast" my metabolism is, i just know i eat very healthy & exercise regularly in order to maintain my ongoing/slim weight (basically, I work at it, I can't just eat whatever I want or I will indeed gain like an average person). I think weight. I'd also say metabolism though, but Idk much about that to comment on it. In the pdf link below I think it talks some about the pharmacokinetics of meds. As an example of various med dosing: http://clincalc.com/kinetics/obesitydosing.aspx --------------- https://www.ncbi.nlm.nih.gov/pubmed/11020136 Quote The dosage of these drugs should be based on the ideal bodyweight (IBW). However, some of these drugs (e.g. antibacterials and some anticancer drugs) are partly distributed in adipose tissues, and their dosage is based on IBW plus a percentage of the patient's excess bodyweight. There is no systematic relationship between the degree of lipophilicity of markedly lipophilic drugs (e.g. remifentanil and some beta-blockers) and their distribution in obese individuals. The distribution of a drug between fat and lean tissues may influence its pharmacokinetics in obese patients. Thus, the loading dose should be adjusted to the TBW or IBW, according to data from studies carried out in obese individuals. Adjustment of the maintenance dosage depends on the observed modifications in clearance. Our present knowledge of the influence of obesity on drug pharmacokinetics is limited. Drugs with a small therapeutic index should be used prudently and the dosage adjusted with the help of drug plasma concentrations. ------------------- Here is a 14-page PDF file that is interesting, and explains things more. I didn't read the entire 14 pages, just the part (scroll to): "Determining an Obese Patient’s Medication Dose" http://www.ashp.org/DocLibrary/Bookstore/P4818/Sample-Chapter.pdf I hope this helps. Link to comment Share on other sites More sharing options...
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