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Lamictal/Lamotrigine - does this side effect go away?


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Hi there. I am taking Apo-Lamotrigine on 50mg. I just started it a few days ago, although I was on Mylan-lamotrigine (1 month) and GSK Lamictal (1 month - best results I think, but they were all close). I stopped mylan due to weight gain and water retention. I had a lot of side effects on brand name as well. I think many would go eventually. I had vertigo on both. I definitely had eye twitching on Lamictal and slight rashes (non SJS, I'm pretty sure), bruising, possibly thinner blood, and a lot of water retention again. I felt something in my stomach and was so bloated at times that I looked pregnant (I'm a male!!!). I am actually quite lean and thin.

I'm on Apo-lamotrigine now, as I tried it again but chose a variant with no lactose. I KNOW that taking care of depression, bipolar II is a serious issue and I don't condone people going off meds.I just am at odds with the side effects - the fluid retention and hair shedding.

My hair thinned out a lot on Adderall of all things (I think I had telogen effluvium + the genetics for hair loss). I never had any major hair loss till then or after though. I had a full head of hair, and still look like I do. If anything its more like "Female pattern" hairloss or diffuse thinning. It thinned out more since September and that's when I started trialling lamotrigine. I have a lot of stress too, but I think its connected. I'm also on finasteride (something I never ever wanted to go on), taking it ever 2 days. 

Anyways my main concern is Fluid retention..... I look bloated on lamotrigine (possibly all variants to some degree) and that's mostly why I kept quitting it. It was a final effort to try this one, apo-lamotrigine (lactose-free!) I'm going to get a surgery in a couple months most likely, and its related to weight. It's to correct a tiny bit of excess skin I have after losing a significant amount of weight.

It's been like 10 years since I considered that or realized the issue and I'm definitely going to get it done this year (unless they tell me for whatever reason I'm not safe to get it). If I look "out of shape" on lamotrigine, I'm definitely not going to continue to take it. At the same time, I am quite fit and my results would show quite well post surgery and recovery - for sure without the med, and possibly even if I take it.

Has anyone has water retention for weeks or months on lamotrigine and then it went away? Does hair shedding stop and generally grow back? I am doing the surgery to benefit me and have my hard work and everything show and continue to improve fitness and life... so I don't want to act against that. Same thing with hair.. I'm trying to better my life and keep my hair and make a brighter future..... It seems that even though *I think* lamotrigine works for me, it might just not be for me. I've read conflicting reports and I know there's a lot of trial and error... but maybe someone had similar doubts about this med and stuck it through and all was well?

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23 minutes ago, MNK99 said:

Hi there. I am taking Apo-Lamotrigine on 50mg. I just started it a few days ago, although I was on Mylan-lamotrigine (1 month) and GSK Lamictal (1 month - best results I think, but they were all close). I stopped mylan due to weight gain and water retention. I had a lot of side effects on brand name as well. I think many would go eventually. I had vertigo on both. I definitely had eye twitching on Lamictal and slight rashes (non SJS, I'm pretty sure), bruising, possibly thinner blood, and a lot of water retention again. I felt something in my stomach and was so bloated at times that I looked pregnant (I'm a male!!!). I am actually quite lean and thin.

Anyways my main concern is Fluid retention..... I look bloated on lamotrigine (possibly all variants to some degree) and that's mostly why I kept quitting it. It was a final effort to try this one, apo-lamotrigine (lactose-free!) I'm going to get a surgery in a couple months most likely, and its related to weight. It's to correct a tiny bit of excess skin I have after losing a significant amount of weight.

It's been like 10 years since I considered that or realized the issue and I'm definitely going to get it done this year (unless they tell me for whatever reason I'm not safe to get it). If I look "out of shape" on lamotrigine, I'm definitely not going to continue to take it. At the same time, I am quite fit and my results would show quite well post surgery and recovery - for sure without the med, and possibly even if I take it.

Has anyone has water retention for weeks or months on lamotrigine and then it went away? Does hair shedding stop and generally grow back? I am doing the surgery to benefit me and have my hard work and everything show and continue to improve fitness and life... so I don't want to act against that. Same thing with hair.. I'm trying to better my life and keep my hair and make a brighter future..... It seems that even though *I think* lamotrigine works for me, it might just not be for me. I've read conflicting reports and I know there's a lot of trial and error... but maybe someone had similar doubts about this med and stuck it through and all was well?

I have been on Lamictal as long as you have. I haven't really been experiencing the bloating, but an annoying related side effect that i have is urinary frequency (peeing an excessive amount every 30 minutes it seems). I think this med alters sodium balance. Do you eat alot of salt? That will often cause bloating and water retention. I drink 2 large coffees every morning, so perhaps this is also acting as a dieretic expelling excess liquid. You could try drinking 3 coffees throughout the day to see if that helps?

I don't know what else to say. I feel totally meh, despite being more even/balanced overall on Lamictal. My pdoc actually mentioned going off of it because I'm still highly symptomatic & have resistant dysthymia. I will only taper a bit, I'm too afraid of getting rebound withdrawal type effects (I'm sensitive to that.) I will go down to 100mg and see. Most people here absolutely love the med & I will admit it's the one med I've tried with the least amount of side effects (esp as far as no weight gain and sedation) Everyone reacts differently though. Has your pdoc listened to your concerns and/or suggested anything else? Or a possible med tweak?

Edited by Blahblah
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Hi. Yeah my Pdoc has been mostly amenable to changing the dose and such. He is admittedly not a bipolar expert. I originally saw him for the ADHD I have. 

The doctor that diagnosed me with BPII gave him notes that suggested trying either Latuda or lamotrigine. I tried the first generic last September and quit in October. Then the brand name in January-February. Then this version in March after being off a couple weeks. I do have salt, but I cycle calories and do alternate day fasting or at least intermittent day fasting. And that's helped metabolism and most other effects from anything I do (lifestyle or medication) wise before this. I didn't eat nearly enough the last 3 days (not good) but for instance there is fluid retention still. I do eat meat and get takeout once every couple days, but try and keep it healthy - meats and vegetables. I am kind of extreme and keep carbs under 100g and even under 40g at times. My doctor (that prescribes the ADHD med and the Lamotrigine) isn't sure what to do. He is going to write the other doctor (Bipolar specialist) to see if there's other options and if such side effects go away. I am very vigilant and despite my disorganization I notice everything... SO maybe I'm sensitive to things and some things woldn't bother others, but because I'm me, I notice it... and I can't commit to it. I've been on maybe 11-12 meds over the past 10 years, most no longer than a couple weeks. Some were SSRI's and SNRI's. The only ones longer than a year would be Effexor (huge mistake!!! considering the bipolar) and Dexedrine. So for me it DOES seem better than nearly everything I've tried. It is my first "bipolar med" or mood stabilizer. I want to like it but damn.

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22 minutes ago, MNK99 said:

Hi. Yeah my Pdoc has been mostly amenable to changing the dose and such. He is admittedly not a bipolar expert. I originally saw him for the ADHD I have. 

 I do have salt, but I cycle calories and do alternate day fasting or at least intermittent day fasting. And that's helped metabolism and most other effects from anything I do (lifestyle or medication) wise before this. I didn't eat nearly enough the last 3 days (not good) but for instance there is fluid retention still. I do eat meat and get takeout once every couple days, but try and keep it healthy - meats and vegetables. I am kind of extreme and keep carbs under 100g and even under 40g at times. My doctor (that prescribes the ADHD med and the Lamotrigine) isn't sure what to do. He is going to write the other doctor (Bipolar specialist) to see if there's other options and if such side effects go away. I am very vigilant and despite my disorganization I notice everything... SO maybe I'm sensitive to things and some things woldn't bother others, but because I'm me, I notice it... and I can't commit to it. I've been on maybe 11-12 meds over the past 10 years, most no longer than a couple weeks. Some were SSRI's and SNRI's. The only ones longer than a year would be Effexor (huge mistake!!! considering the bipolar) and Dexedrine. So for me it DOES seem better than nearly everything I've tried. It is my first "bipolar med" or mood stabilizer. I want to like it but damn.

Well, I do know abruptly going on & off of Lamictal will cause problems. It takes awhile to properly build in your system. Also you really need to give a med 6 weeks to adjust. If you wait only 2 weeks, you are unable to really tell whether the side effect will go away or not. Many side effects only last a week or so then go away.

Your erratic diet may have something to do with the water retention (note I'm no doctor or nutritionist) 40 grams carbs is very little for a male that is active. I know i try to eat smaller portions (with snacks like almonds or whole grain rice cakes) throughout the day to keep my electrolites, sugars & potassium balanced. Your body absolutely needs sugar to function, especially cognitively (even if just a couple fruits per day). Maybe you are throwing your body into a diabetic mode and it is holding onto the water? You are essentially starving yourself by not eating for 3 days. It will store up the calories/hold onto fat or anything it can and slow your metabolism I'd think. Think balance. I don't know if fasting every other day is really a good thing. I've heard once per month is better/OK as a cleanse restart habit. Anyway, just something to think about!

Edited by Blahblah
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1 hour ago, MNK99 said:

I have a lot of stress too, but I think its connected

I think you are right.

 

1 hour ago, MNK99 said:

Anyways my main concern is Fluid retention..... I look bloated on lamotrigine (possibly all variants to some degree) and that's mostly why I kept quitting it. It was a final effort to try this one, apo-lamotrigine (lactose-free!) I'm going to get a surgery in a couple months most likely, and its related to weight. It's to correct a tiny bit of excess skin I have after losing a significant amount of weight.

I think the lactose in the meds that you are referring to can definitely cause some bloating.  Maybe not to the extent you are talking about, but definitely some ... BTDT when I was in college and after.  Anything with lactose would cause me to bloat out (and have bad gas).  (I did eventually started eating foods with lactose in them again).

I've never had water retention with lamictal and same with hair loss.

When I started with lamictal, I had a great thick head of hair.  And it never fell out unless my thyroid was off (which can cause hair loss) and/or if I experienced severe stress for a prolonged period of time I could count on losing hair  (for me, if I am really stressed for awhile about something, 4-6 weeks later my hair will fall out ... not a lot, but noticeable.  It does come back though in time).  But it wasn't from the lamictal AFAIK.  I never connected the 2.

I know you've talked to your pdoc about this, but have you thought of the bloating being from something else?  It sounds very uncomfortable to be dealing with.

**Have you gotten your thyroid checked recently?  That can definitely cause hair loss.

 

 

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@Blahblah 

Yeah... I know it seems erratic, honestly it may be at times. BUT even so I maintain the same average calories as needed for a decrease in weight. So if my TDEE (total daily energy expenditure) is 2900, and I want a deficit of 1000 I might eat an average of 1800-2200 (for a short time, not forever! Only when "cutting"). But I always reset. Or if I just want to maintain (soon) I might just eat 2600 one day and 3200 the next. 

I know what you mean - balance :) I appreciate it. I guess I've always been erratic in diet and sleep a bit but it balances things out. Like I take my ADHD med in the morning and usually on an empty stomach, and I get my calories in at night, in an eating window. Its hard to explain but I make my macronutrients most the time. It's extreme because of the times where I don't. 

I have reset my metabolism several times. Like when I was  180lb with no further progress and I realized that I was undereating and doing too much cardio, I eventually came to my senses and fixed that. So for 6-8 weeks I reset and eat 500-700 more than my BMR (basal metabolic rate) to bring my metabolism back up. I did recently go from 192 lb (Which is a bit much for me) to 174 or 172lb which is pretty light and nearing my end result. I don't think about weight, just about progress, but yes I admit I'm obsessive about it. 

I don't mean to sound combative or argumentative. I don't think my diet is too too erratic right now but your post does remind me that sometimes it does get there. Also I know it sounds erratic.  That's why I always take breaks and just eat normally, whatever I want for a week or so. See part of the reason to get the surgery done is cuz all the issues of being formerly obese affect my mental health and erratic ways (diet, sleep, anxiety, depression, etc). 

I do wholeheartedly agree with you that starting and stopping the medication isn't good. Most my meds were misdiagnosis or they were for ADHD and didn't have the right sides. I think stimulants and mood stabilizers are the only "right meds" so far. And that's more limited because I need a mood stabilizer that works on depression. Those ones, if they work (one does) I do keep "ON" during work or school. I'm hoping to find something for BPII that's as effective and tolerable as what I have for my ADHD.

Also: You're probably right that fasting every other day isn't a good long term solution and honestly I look nearly the same without it... Its like eat 2500 calories and 1200 -1400 the next day. It was 700 for a bit but that was hard to sustain - but did give me good results. Mostly I get derailed and so I have to be extreme -- in work, fitness regiments, school. It's like I have to function 1000% to make up for the times where it's 30% or less. 

I realize I just made myself look far more erratic in this post. I'm inconsistent and use my hyperdrive to sort out things - but yeah its not sustainable. I fully intend to normalize eating more.

Part of it is I focus better without breakfast, and I was really intent on getting to 10-12% bodyfat and getting my surgery done this year. Part of it is, I feel smarter and more focused getting the work done in the day, and eating at night. 

Edited by MNK99
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@melissaw72

"When I started with lamictal, I had a great thick head of hair.  And it never fell out unless my thyroid was off (which can cause hair loss) and/or if I experienced severe stress for a prolonged period of time I could count on losing hair  (for me, if I am really stressed for awhile about something, 4-6 weeks later my hair will fall out ... not a lot, but noticeable.  It does come back though in time).  But it wasn't from the lamictal AFAIK.  I never connected the 2.

I know you've talked to your pdoc about this, but have you thought of the bloating being from something else?  It sounds very uncomfortable to be dealing with.

**Have you gotten your thyroid checked recently?  That can definitely cause hair loss."

Hi again Melissa, I keep posting the same things in a sense but worded them differently and had different angles. I've been freaking out a lot lately. 

I have not had my thyroid checked lately. It was really weird - the terminal at my University's health clinic when you check in, says "treated for conditions" and "thyroid" was selected... But I never had thyroid treatment so I assume it was some record mixup. Honestly, I did go check everything out many years ago bc of all kinds of random stomach and other issues. But came back clear on a lot. It's been a long time though.... It is possible that the diet protocol (its not "really a diet" - just eating hours are different) may be suitable for strength training but not for the drug I'm taking, as in... maybe I need to eat 3-4 meals now or something like that. 

Anyways, I just don't think it should be this hard. Either something works and doesn't harm me... or I gotta move on. But I know you gotta wait and 1 month isn't long. I'll ask to get my thyroid checked, next time I see my family doctor. I've definitely thought I've had hypo or hyperthyroid at times. I fit more hyperthyroid symptoms but I did have eyebrows shed a lot as well as maybe thinning of eyebrows a bit and hair above my ear. I notice it when on stimulants - it was really scary at first but that was a few years ago.

 

 

 

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1 hour ago, MNK99 said:

I did go check everything out many years ago bc of all kinds of random stomach and other issues. But came back clear on a lot.

Thyroid levels can change ... if you haven't gotten one for many years, IMO I would suggest asking about getting a thyroid level done.  At least a TSH.

Not sure what meds you are on ... My thyroid got messed up and the DR found that it was lithium-induced (in my medical records saying that).  As of right now though (after being off lithium for a long time), I have been in remission for at least 3 years and no longer need medication for it.

1 hour ago, MNK99 said:

But I never had thyroid treatment so I assume it was some record mixup.

I think it is a good idea to ask your family DR to check your thyroid.  I would ask if it an error or not.  If you google "hyperthyroid untreated" and "hypothyroid untreated," you will see things that could (might) happen if your thyroid goes untreated.  (if it is the problem in the first place).

 

 

 

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  • 4 weeks later...

I've found Lamictal to be very benign in terms of side effects. I don't suffer any now.

Perhaps some of the problems might pass with time or be treatable with additional meds but maybe this med just doesn't suit your body chemistry and it would be better to try another.

What does your pdoc think of these side-effects?

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  • 4 weeks later...

I miss it... but My Pdoc says : It probably is the med. The doctor he touched base with said "he hadn't heard those complaints", water retention, hair loss - but clearly --- it does exist. I quit and started again like 6 times, each time - I can run my hand through my scalp in any direction and hair just comes out. I lost a tiny bit of eyelashes too (but may have before at times, I remember my Doctor asking about this as a kid, he asked if I picked them ! Of c not, but I did rub my eyes, allergies or whatever).

Eyebrows fall a bit easier on this med too. Same on dexedrine, but hair loss there is minimal. Adderall (3.5 yrs ago was severe and brief, but did not come back). Lamictal recently was severe too. I think water retention is there on all versions, but worse on Lactose containing versions (incl. brand name). 

I think the Mood Boost is Best on Lamictal. And it's "okay" on one generic and pretty good on another. Hair loss seems to occur on all.

A surgery I mentioned, is happening soon (no date planned, but probably this month), so I probably shouldn't start any other meds. Besides, I can't think of any great choices. 

My PDoc conferred with the Expert on Bipolar... And he suggested to my Pdoc - Latuda or Saphris. My Pdoc mentioned maybe Trileptal. I thought maybe Trileptal and Wellbutrin, but then we are adding 2 drugs. I think Latuda would probably work the best, but I've lost like 100lb plus in my life. From obese to rail thin, or ripped.... So screw it I think.

Though I was like catatonically depressed lots of the time. The hair loss from Lamictal didn't help. I looked like 22 most of my 20's And I can't deal with hair loss, and really confidence and such are more important to me than my disorders, minus the severe depression, social anxiety, and unfocused/ disorganized chaos. So it's like I need something, but choices are not good. I think that I might get some regrowth of hair from Finasteride in the future, but I don't like being on that. And also, it looks like hair thinned from the LTG was all over the place and not miniaturized... so probably not DHT related anyways. Although Fin could help any hair, but of c it isn't great for sex drive. Can't win.

 

I am trying Lithium Orotate / Lithium Aspartate and it actually does help calm me down significantly.Only been a few days, do feel some brain fog - can keep it at one tab per morn then night 5mg each. 

Edited by MNK99
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