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New on Lamictal, getting acne and migraines


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Sunday, Jan 22

I am now on my fifth day of migraines and ready to start digging into the Oxycontin leftover from shoulder surgery in Sept.  Started on Lamictal 2 weeks ago and at first it seemed great.  Definitely could feel it "brushing my opioid receptors" as they say on Crazymeds. 

But after a week I started going hypomanic.  Felt great, sure, but as I understand it, each manic episode sows the seeds of the inevitable depression that follows.  So I reduced my Effexor (no result) then Weds. cut it out entirely.  That stopped the hypomania cold, but brought on this five day migraine.  So I brought the Effexor back, and fast.  Migraine, however, has continued.  Plus acne (and I'm over 40)

Current meds:

am

18.75 mg Effexor (yes that is correct, I cut a 75 mg tab into quarters)

105 mg Armour -- (thyroid gland was surgically removed)

25 mcg Cytomel

Tri-est

DHEA 25 mg

pm

50 mg. Topamax

50 mg. Lamictal

12.5 mg. Trazodone (cut a 100 mg. tab into eighths)

I'd been taking 75 mg/day Topamax since June, but getting serious cognitive impairment.  Stupimax has some really nice features, I lost 8 lbs, had NO migraines, and it put an end to RLS (restless leg syndrome, which I've had since I was a kid).  But the stupidity was ruining my career, hence the switch to Lamictial--so I can have my career ruined by migraines instead.

I am recently post-menopausal (had my last period in August) so am taking bio-identical hormones (tri-est, testosterone and dhea). 

I was dx as ultra-rapid cycling bipolor II, after ten unfortunate years on Zoloft, so Topamax was the first choice.  But the memory loss and general dopiness was intolerable.

What can anyone tell me about lamictal and migraine?  I have stayed on the Topamax cause I'm afraid if I stop it the migraines will REALLY kick in.  I have stopped the testosterone cream due to  acne that I'm getting just since starting Lamictal.  I have some Amerge but can't tolerate Amerge and Topamax together, the combination makes me feel stay-in-bed sick.  I just took an anti-nausea pill (phenergan) and an extra-strength tylenol. 

Will these migraines go away?  When?  What migraine med should I ask for to get me through? The nausea is really worse than the paiin in my head.

What about Lamictal and acne?  Is this common?  I haven't had acne for 25 years, what should I ask for?

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You'll find that quite a few Lamictal users around here have had excruciating headaches and/or muscle pain when we first started it, or shortly into it. For the majority of us with these side effects, they do go away -- and the positive results from the Lamictal are worth our hanging in there through the bad stuff.

Personally, these SEs didn't hit me until a few weeks in, then lasted about a month. Thought I'd never get through it, but I did.

Some previous threads you may want to check out:

lamictal hair-raising headache, is it the lamictal or just me?

Lamictal and my aching back, chest, BODY! Lamictal and muscle pain

Lamictal & sore muscles, OUCH!

Also, regarding the Lamictal acne, here's a good thread:

Skin/complexion concerns? just curious - number_6 (on page 1) and ncc1701 (on page 2) especially talk about the Lamictal/acne connection and what they've found that works for them.

Oh, also...because of the hormones you're on, you may find you'll need more Lamictal to get to your maintanance dose. Birth control pills and hormone replacement cause Lamictal to leave your system more rapidly. Here's one thread where we've talked about it: Lamictal and OCP, Options for birth control (even though this topic title says "birth control" it does apply to those of us on hormone replacement.)

Best wishes -- and keep asking questions!

revlow

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Hi Goddess, welcome!

Lamictal can be one of those drugs that you love, and love to hate until the side effects taper off.  The side effects usually appear with each dosage increase, then ease off.

The key to accomodating Lamictal is slow and small dosage increases.  What that level is varies from person to person.

Headaches?  Yes, classic lamictal side effect.

Skin condition exacerbated?  Yes, classic lamictal effect.

If I interpreted you post correctly you are at 50mg and 5 days at that level on the second week of lamictal. The starter pack (if you got one) takes 5 weeks to get to 100mg.    I can't quite recall but I think the starter pack has 2 weeks at 25mg, and 2 or 3 weeks at 50mg before getting to 100mg.

So, it sounds like you are titrating upward faster than Glaxo recommends, and definitely too fast for your body. The most logical thing to do would be to immediately drop back to 25mg, get stabilized with symptoms and then start a slower increase. You could split the 25mg pills, yielding 12.5mg and add them to a 25mg for a total of 37.5mg.  Stay at that level for at least a week until the side effects ease off. Then when you are comfortable, increase by 12.5mg up to 50mg.

The biggest danger from Stevens Johnson Syndrome "the rash" is typically caused by increasing too quickly.

Don't do this on your own.  Call your Pdoc first thing Monday, tell him what is going on and ask about this strategy.

Hope you feel better,

A.M.

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Thank you Air Marshall, that makes sense.  Actually I have followed the starter pack exactly, two weeks at 25 mg, and last night (Saturday night) was my first dose of 50 mg. Lamictal. 

But I think that migraine is to some degree self-perpetuating, and I got one started by cutting the Effexor in half on Tues morning and then eliminating it entirely on Weds morning.  By Weds at 4 pm the migraine had begun and I've had it at least part of every day since then. 

I will go back to just 25 mg. tonight. 

I hope you are right, that the SE ease off after a bit.  Cause I sure do need a mood stabilizer and had heard great things about Lamictal.  Thanks for your help, both you and Reviow.

Hi Goddess, welcome!

Lamictal can be one of those drugs that you love, and love to hate until the side effects taper off.

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Hi, Goddess...

If I'm reading you correctly, you're thinking it's more the decrease in Effexor causing the problem, right? You might want to read this thread: effexor reduction headache.

Good luck. Keep us posted, okay?

revlow

<{POST_SNAPBACK}>

Thanks, Revlow.  I think it's a combination.  I tried going off the Effexor back in November and never got any migraines, but did get flat out purple-lipped rage that made me want to kill, so I went back on it after a week. But I was on 75 mg/day of Topamax then and no Lamictal.

I am remembering now, that I DID have headaches for several days after first starting the Lamictal (3-4 days) and they then went away.  Which corrorborates what some folks have said about headaches with each dosage increase. 

i am willing to hang in there.  Maybe tomorrow I will get some Imitrex.  I have a full bottle of percocet and one of oxycontin but I heard they can cause nausea, don't want any more of that!

Despite all this, I am grateful to finally have a dx and to finally begin to understand why my life has been the way it's been.  (I actually self-diagnosed over two years ago, but when I went to the county mental health facility and asked for Lamictal in December 2003, they said I had narcissistic personality disorder and drugs wouldn't help me.) I am grateful to have found this forum and for the helpful people here.

Goddess 

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Just wanted to add in my own experience...I have suffered from migraines w/aura since childhood, and did notice an increase in frequency when I started Lamictal. But I went up on it verrrrry sloooowly and gradually the migraines went away. I have been on Lamictal for four? or four and a half? months now, and my migraines are pretty much back to what they were before. I hope it works out the same for you and that you are feeling better soon!

~Faith

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Wow, seems like you've been through a bunch...

I myself have only been diagnosed with BPII, but I know that I'm ultra radian cycling.  I can't keep it together from one hour to the next.

Anyway, I've been on Effexor for a while and only got a headache when my dose was halved, but I know it's common when you cut back on this med...did you try to half your capsules??  As for Lamictal, haven't had any side effects except for sweaty nights, which aren't really a big deal.  I hope this helps the BP, that's what I'm waiting for....

;)

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Heya Goddess,

Hi and welcome to CB!

(Stay off the computer for three days and miss all the fun, argh ;) )

Well, revlow and AM have pretty much said whatever I would have said.

No headaches for me (thank goodness -- I never had tehm before and I don't know how I would deal with it).

But yeah, I did have acne, almost as bad as the old days before I started birth control.  That lasted about a month or so, and I used a lot of topical BenzaClin -- or maybe ClindOxyl -- they're the same thing, and bleached my pillow, but worked.

The acne seems to have setttled down, not perfect, but now it's just a couple of zits here and there like all those obnoxious commercials.

At any rate, good luck with your cocktail -- you're right, the more meds you have on board, the harder it is to sort out what effects are from what.

--ncc--

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Heya Goddess,

Hi and welcome to CB!

(Stay off the computer for three days and miss all the fun, argh :) )

Well, revlow and AM have pretty much said whatever I would have said.

No headaches for me (thank goodness -- I never had tehm before and I don't know how I would deal with it).

But yeah, I did have acne, almost as bad as the old days before I started birth control.

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