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2 hours ago, argh said:

Standard titration isnt for everyone. If I took the standard route I would have gone from 100 to 200. Instead I went to 150. This way I didn't get any weird harmless rash. As you are med sensitive, you might be able to get away with less. Maybe if you're closer to mdd you can get away with less too.

Yeah that's a really big jump. My psychiatrist got back to me again and said why not try 75 for three days and if feeling OK then go up to 100? I thought that sounded reasonable. 

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After 25mg for two weeks and 50mg for two weeks you can make jumps on a weekly basis in increments of 50mg.

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5 hours ago, browri said:

After 25mg for two weeks and 50mg for two weeks you can make jumps on a weekly basis in increments of 50mg.

Ah thank you 😊 good to know! 

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Here's the  official GSK  titration schedule. There's no MDD titration schedule so you go by bipolar.

Table formatted a bit weird in paste.

https://www.gsksource.com/lamictal

Table 5. Escalation Regimen for LAMICTAL in Adults with Bipolar Disorder
 

In Patients TAKING Valproatea

In Patients NOT TAKING Carbamazepine, Phenytoin, Phenobarbital, Primidone,b or Valproatea

In Patients TAKING Carbamazepine, Phenytoin, Phenobarbital, or Primidoneb and NOT TAKING Valproatea

Weeks 1 and 2

25 mg every other day

25 mg daily

50 mg daily

Weeks 3 and 4

25 mg daily

50 mg daily

100 mg daily, in divided doses

Week 5

50 mg daily

100 mg daily

200 mg daily, in divided doses

Week 6

100 mg daily

200 mg daily

300 mg daily, in divided doses

Week 7

100 mg daily

200 mg daily

up to 400 mg daily, in divided doses

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Soooo is it pretty common to have increased bruising on lamotrigine? Cos far out I am getting a lot of bruises from God knows what. I've got one on my arm that's pretty sore and I can't for the life of me recall hitting it or being slammed into. I've also got a really dark one on my leg! They must be coming from the tiniest things. 

Or would bupropion be a more likely culprit? 

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I would more likely think lamotrigine. But I can't be sure. And I also don't know that it's considered a serious side effect either unless of course they start showing up everywhere rapidly. But really with lamotrigine, the only thing that you really have to be worried enough about to call the doctor is the rash.

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5 hours ago, Melancholya said:

Soooo is it pretty common to have increased bruising on lamotrigine? Cos far out I am getting a lot of bruises from God knows what. I've got one on my arm that's pretty sore and I can't for the life of me recall hitting it or being slammed into. I've also got a really dark one on my leg! They must be coming from the tiniest things. 

Or would bupropion be a more likely culprit? 

I got easy bruising once I added lamotrigine.

Skin sensitivity was another however.. Or we now have radioactive mosquitoes in my neck of the woods.

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19 hours ago, browri said:

I would more likely think lamotrigine. But I can't be sure. And I also don't know that it's considered a serious side effect either unless of course they start showing up everywhere rapidly. But really with lamotrigine, the only thing that you really have to be worried enough about to call the doctor is the rash.

Thanks! I'm not worried about it being serious. Was just something I noticed that had me wondering :) (lamotrigine must be helping a lot because I am not anxious over any of this stuff anymore!) 

19 hours ago, argh said:

I got easy bruising once I added lamotrigine.

Skin sensitivity was another however.. Or we now have radioactive mosquitoes in my neck of the woods.

I had some skin itchiness/tingling around my eyes when I first started but haven't had any of that for a while now. Is your skin sensitivity ongoing? That sucks if so. 

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Another Q. If I wanted another child I'd definitely have to stop lamotrigine right? My pdoc did say they prescribe it in pregnancy but I've seen other stuff about it online that seems to suggest otherwise. And in breastfeeding it'd be a no-go right? 

Hubby and I are happy with just our one at the moment but are open to the possibility of having another kid later (like years later). But I am loving this med so it'd be a real shame to have to come off and go back on an SSRI. 

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5 minutes ago, Melancholya said:

Another Q. If I wanted another child I'd definitely have to stop lamotrigine right? My pdoc did say they prescribe it in pregnancy but I've seen other stuff about it online that seems to suggest otherwise. And in breastfeeding it'd be a no-go right? 

Hubby and I are happy with just our one at the moment but are open to the possibility of having another kid later (like years later). But I am loving this med so it'd be a real shame to have to come off and go back on an SSRI. 

https://womensmentalhealth.org/posts/clinical-update-lamotrigine-lamictal-breastfeeding/

most info I found has said its safe (usually). I know a pdoc who feels that it is one of the safest psych meds during pregnancy, but obviously not everyone agrees 

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2 minutes ago, Melancholya said:

Another Q. If I wanted another child I'd definitely have to stop lamotrigine right? My pdoc did say they prescribe it in pregnancy but I've seen other stuff about it online that seems to suggest otherwise. And in breastfeeding it'd be a no-go right? 

Hubby and I are happy with just our one at the moment but are open to the possibility of having another kid later (like years later). But I am loving this med so it'd be a real shame to have to come off and go back on an SSRI. 

That might be a good idea. In the states, it's category C. That means it's known to cause defects in animals, but there's no data for humans. From what i see this is a "weigh the benefits" sort of deal. It seems that most mood stabilizers, AC, lithium, AAPs have that classification. Sertraline is also C for what it's worth.

Buspar is a B, so hope that will help you.

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13 hours ago, Iceberg said:

https://womensmentalhealth.org/posts/clinical-update-lamotrigine-lamictal-breastfeeding/

most info I found has said its safe (usually). I know a pdoc who feels that it is one of the safest psych meds during pregnancy, but obviously not everyone agrees 

this would be correct. I believe the safest anticonvulsant medications during pregnancy are Lamictal (lamotrigine) and Keppra (levetiracetam). That being said all anti-convulsants carry some sort of warning about birth defects because there is some data, there just is less data for some medications, like in this example. They have some indication of problem in animals but lack much if any supporting data in humans. Doesn't mean they haven't tested the theory, just means there's less data. Not for lack of trying I imagine. Lamictal is an old medication. I do believe Keppra is newer, so perhaps the latter's excuse is that there hasn't been enough time to collect the data. But the former has been around for a long time, and I imagine that birth defects would have been reported by now if there were any.

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On 6/16/2019 at 8:19 PM, Iceberg said:

25 mg for 2 weeks, 50 for 2 weeks than 100 - from there some go to 200 or even more... but I don’t think that would be the case for unipolar depression. At least not right away. taking it slow most people avoid the sjs 

I did a slower titration than that. I think slower titrations are always an option, and we forget that.

Starting LTG can be rough. It often makes people feel agitated and irritable. That goes away. I take it as a mood stabilizer, which is the bedrock of any bipolar person’s cocktail. When it was first prescribed to me, it was also a hail-Mary for depression, and it worked pretty well. I’ve been taking it since...2011?

As to skin problems, well. My skin is sensitive and loves to react to anything at the drop of a hat. I got a few minor rashes, some of which were a little itchy, but the went away quickly. I also got a few weird zits. It looked like one tiny pore at a time would just blow a white bubble. I’d drain it and it would heal, and that was that.

SJS is incredibly rare, and it does not just sneak up on you. It’s not as if you’ll be fine at 5:00 and dropping dead at 9:00.

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3 hours ago, Gearhead said:

I did a slower titration than that. I think slower titrations are always an option, and we forget that.

Starting LTG can be rough. It often makes people feel agitated and irritable. That goes away. I take it as a mood stabilizer, which is the bedrock of any bipolar person’s cocktail. When it was first prescribed to me, it was also a hail-Mary for depression, and it worked pretty well. I’ve been taking it since...2011?

As to skin problems, well. My skin is sensitive and loves to react to anything at the drop of a hat. I got a few minor rashes, some of which were a little itchy, but the went away quickly. I also got a few weird zits. It looked like one tiny pore at a time would just blow a white bubble. I’d drain it and it would heal, and that was that.

SJS is incredibly rare, and it does not just sneak up on you. It’s not as if you’ll be fine at 5:00 and dropping dead at 9:00.

Holy shit yeah. I get zits again. I scar really easily. Bug bites look like they're radioactive and I burn despite the fact that I could tan. Contact dermatitis, it looks like I've been carrying arms full of pine cones for miles.

Fwiw my tritation was super slow as I had to start over in the middle due to a rash scare.

Got me up to 200mg eventually.

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1 hour ago, argh said:

Holy shit yeah. I get zits again. I scar really easily. Bug bites look like they're radioactive and I burn despite the fact that I could tan. Contact dermatitis, it looks like I've been carrying arms full of pine cones for miles.

 

Oh yeah. I forgot to mention that my skin heals really, really slowly, scars easily, sunburns even more easily than it used to (which is saying something), and goes bugfuck if I use a lotion, soap, etc. that it doesn’t like. 

It’s still worth it.

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27 minutes ago, Gearhead said:

Oh yeah. I forgot to mention that my skin heals really, really slowly, scars easily, sunburns even more easily than it used to (which is saying something), and goes bugfuck if I use a lotion, soap, etc. that it doesn’t like. 

It’s still worth it.

it totally is. scent free laundry detergent, scent free lotion (the amazon generic aveeno is the best), castile soap, etc.

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Interesting. I've been getting little pimples on my thighs, which isn't new, but now there's heaps more of them, lol. Yay for being sexy. I also have a lot more bruises these days. 🤔 

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I’ve only recently heard people talk about bruising more easily. I can’t address that one. I’ve always bruised like a banana. 

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21 minutes ago, Gearhead said:

I’ve only recently heard people talk about bruising more easily. I can’t address that one. I’ve always bruised like a banana. 

I've heard Zinc supplements are good to take for bruising (not sure why?)

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