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Default Oct 14, 2020 at 09:56 PM
  #1
Does anyone here feel, or have felt, very shaky from your head through your jaw, shoulders, arms from medication? Not the standard "med hand tremor"- this is more of an entire upper body trembling experience. Also fairly short of breath and fatigued?

If you have (or do), any idea which meds might cause such sensations?

I'm asking because well, obviously, I am having those feelings. In the past month my Lamictal was increased from 350 to 400. My perphenazine (Trilafon) from 16mg to 20mg.

Mentally and emotionally I feel quite well. Stable. Physically, I feel like I'm going to pass out. All I do is keep nodding out. I feel like Dorothy in the poppy field. I feel like crap, unless I'm asleep.

This has been going on for several weeks. I'm thinking it's the Lamictal, but I believe my pdoc will deny that. I would tend to point a finger at the AP; however, I was feeling this way prior to raising the dose of the AP, yet it might be slightly worse. An interaction, perhaps? Too bad, this is how psych meds make people feel? I'm somewhat at a loss.

My pdoc will pretty much leave it to me to decide what I want to do. Any and all ideas welcomed.

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Default Oct 15, 2020 at 10:42 AM
  #2
Well, now I'm kinda worried. I checked around online and apparently the type of body tremor I'm having can be a sign of Lamictal toxicity. I didn't know there was such a thing; I thought toxicity occurred only from lithium.

Has anyone here had a toxic reaction to a med? How did you know it was toxic?

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Default Oct 15, 2020 at 12:17 PM
  #3
Tegretol- I didn't know I was toxic until I was in the hospital and did blood work and they said that's why I was being super aggressive and blacking out all the time.
Do you know if there's a blood test for lamictal toxicity like there is for lithium, depakote and tegretol?

Are there any meds you're decreasing at the time and this could be withdrawal?
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Default Oct 15, 2020 at 12:25 PM
  #4
I'm on busiprone and deluxitone. Both give warning signs for toxicity I think, on the informational pamphlet that confess with my bottle. This has been the case for most antidepressants and acro anxiety meds I've tried
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Default Oct 15, 2020 at 02:22 PM
  #5
Thank you both! I have never realized that (aside from lithium) a med could be toxic if someone takes the recommended dose. Yikes. Well, fortunately I have a telehealth appt. with my pdoc tomorrow. She's moody, though. Hopefully she'll be in a helpful mood tomorrow.

Sapien, thanksd, no...it's not withdrawal. It's been going on for weeks, I kept thinking I was just tired. Then yesterday it hit me like...something is not right.

According to the info I'm reading online there is a test for Lamictal levels. I had no idea. It's not like my pdoc ever mentioned it to me


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Default Oct 15, 2020 at 05:06 PM
  #6
Hi BethRags. Obviously you won't know until your pdoc gets to the bottom of it, but my guess would be that perhaps the Lamictal is the culprit. I remember reading somewhere (and maybe even being told) that 400 mg and above of Lamictal is usually only prescribed for people with epilepsy/seizures. I did know that there is a Lamictal level blood test, but was told that it is usually only given to people with epilepsy/seizures because of the higher doses prescribed to them.

I did google "Lamictal shaking" and there was a result showing that as a possible side effect. I believe I have also heard of someone (only maybe one person over the years) mentioning such a side effect for Lamictal. I wouldn't think that that would be a no-go for Lamictal. Perhaps just a little time to adjust? Or a dose decrease?

I've never taken doses of perphanazine as high as 16 or 20 mg. The most I ever took, in the past, was 12 mg, but did take it with a large dose of Geodon and a few moodstabilizers (Lithium, Tegretol XR, and small dose Lamictal). I didn't experience any shaking on that cocktail, but we are all different.

I hope you get to the bottom of this issue soon. It does sound very uncomfortable.
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Default Oct 15, 2020 at 06:07 PM
  #7
Quote:
Originally Posted by Soupe du jour View Post
Hi BethRags. Obviously you won't know until your pdoc gets to the bottom of it, but my guess would be that perhaps the Lamictal is the culprit. I remember reading somewhere (and maybe even being told) that 400 mg and above of Lamictal is usually only prescribed for people with epilepsy/seizures. I did know that there is a Lamictal level blood test, but was told that it is usually only given to people with epilepsy/seizures because of the higher doses prescribed to them.

I did google "Lamictal shaking" and there was a result showing that as a possible side effect. I believe I have also heard of someone (only maybe one person over the years) mentioning such a side effect for Lamictal. I wouldn't think that that would be a no-go for Lamictal. Perhaps just a little time to adjust? Or a dose decrease?

I've never taken doses of perphanazine as high as 16 or 20 mg. The most I ever took, in the past, was 12 mg, but did take it with a large dose of Geodon and a few moodstabilizers (Lithium, Tegretol XR, and small dose Lamictal). I didn't experience any shaking on that cocktail, but we are all different.

I hope you get to the bottom of this issue soon. It does sound very uncomfortable.


Soupe, thank you so much for your input and information. I, too, suspect that Lamictal is the culprit. Possible, too, that adding in the high dose of perphenazine has an interaction with the Lamictal, too. I have the feeling a decrease in Lamictal is in order.

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Default Oct 15, 2020 at 10:46 PM
  #8
When I switched from divalproex (depakote) to lamotrigine a couple of years ago, I learned that lamotrigine can interact with other drugs. When taken with divalproex, it can double the potency of lamotrigine and is listed as a "major" interaction with it on drugs.com.

I did a quick search on lamotrigine and perphenazine and it is listed as a "moderate" interaction.
Here is a list of some the symptoms one should watch out for when on these two drugs.

Lamotrigine and perphenazine Drug Interactions - Drugs.com
So, it kind of looks like it may be the lamotrigine as you suspect.
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Default Oct 16, 2020 at 07:06 AM
  #9
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Originally Posted by RockyRoad007 View Post
When I switched from divalproex (depakote) to lamotrigine a couple of years ago, I learned that lamotrigine can interact with other drugs. When taken with divalproex, it can double the potency of lamotrigine and is listed as a "major" interaction with it on drugs.com.

I did a quick search on lamotrigine and perphenazine and it is listed as a "moderate" interaction.
Here is a list of some the symptoms one should watch out for when on these two drugs.

Lamotrigine and perphenazine Drug Interactions - Drugs.com
So, it kind of looks like it may be the lamotrigine as you suspect.

I am grateful to you for your post! Thank you. I believe the interaction has hit me especially hard. I will see my pdoc today, so the information you've given to me will be especially helpful.

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Default Oct 16, 2020 at 02:33 PM
  #10
I just want to say I hope you get it figured out, Beth. That sounds like no fun at all.

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Default Oct 16, 2020 at 05:04 PM
  #11
Thanks for the input and well wishes!

The appt. with my pdoc was productive. She said I'm having dystonia (the shaking and muscle rigidity). The extreme sleepniess is, she thinks, from the high dose of Trilafon.

Dropping Lamictal down some, dropping Trilafon down some, adding a small amount of Cogentin to see if it offsets the muscle rigidity.

x fingers crossed x

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Default Oct 17, 2020 at 10:55 AM
  #12
Good luck Beth. I am glad to hear she listened go your concerns and that you have a reasonable plan.
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Default Oct 17, 2020 at 07:02 PM
  #13
I missed this thread. I hope you are better. Abilify at 25 finally did this to me after 12 solid years on it.

Hugs!

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Default Oct 19, 2020 at 11:51 AM
  #14
Quote:
Originally Posted by BethRags View Post
Thanks for the input and well wishes!

The appt. with my pdoc was productive. She said I'm having dystonia (the shaking and muscle rigidity). The extreme sleepniess is, she thinks, from the high dose of Trilafon.

Dropping Lamictal down some, dropping Trilafon down some, adding a small amount of Cogentin to see if it offsets the muscle rigidity.

x fingers crossed x
This sounds like a good plan- dropping Lamictal and Trilafon and adding Cogen! I hope it works quickly for you!

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