[tnlibrarian]

I saw my psych Friday and she decided major changes to my meds were needed. She changed my Lamictal from 200 mg to 400 mg. She also pulled me off 75 mg Seroquel and put me on 40 mg Geodon. She told me to quit the Seroquel cold turkey and take Geodon and Ativan at night. She also told me to take the two Seroquel pills at the same time. I did that and got violently ill. I have never vomited that hard. At the same time I was having terrible vertigo. Tonight I'm being hit with nausea, diarrhea and I can't sleep.

Are the Geodon and Lamictal a bad combo? And is it a good idea to go from 200 mg of Lamictal to 400 mg without a gradual increase? Is it okay to quit 75 mg of sudden release Seroquel cold turkey?

[Anika.]

I have no idea... I would call your Pdoc asap tho, and also I would talk to the pharmacist since they are usually more knowledgeable. That is actually pretty concerning. I am sorry that you are so ill. I only had that happen to me once and it was with cogentin, so I am not much help, sorry.

I hope you get some answers and start feeling better soon.

[bluemountains]

Hi Becca,
My pdoc had me increase my dosage of lamictal very slowly, and I thought this was protocol for this drug. Also, she will only change one drug at a time. It seems rather drastic to change so many meds at once.
Are you seeing the same pdoc as usual? Obviously all of the sudden changes are causing your negative reactions. I would call the pdoc asap.
Bluemountains

Originally Posted by tnlibrarian

... She changed my Lamictal from 200 mg to 400 mg. She also pulled me off 75 mg Seroquel and put me on 40 mg Geodon. She told me to quit the Seroquel cold turkey and take Geodon and Ativan at night. She also told me to take the two Seroquel pills at the same time. I did that and got violently ill.
...And is it a good idea to go from 200 mg of Lamictal to 400 mg without a gradual increase?...

First, just for clarification, you meant to say she had you take the 2 Geodon at the same time, right? (Not Seroquel, as that's the one she was taking you off, ya?) That said, sorry to say I can't speak to either of them. But on the Lamictal, (excluding ramp up of course) I've been on dosages ranging between 200 and 400 mg. Can't remember (and would take forever to look up) if I've ever gone directly from one to the other, but if there was a mid-dose it wasn't for long at all. Ok, now for the only truly useful relevant experience I can offer...I'd never had any trouble whatsoever with Lamictal, BUT when put on 400 mg, it threw me for a loop. There were 2 reactions, but the one I remember was visual. I couldn't focus, and remember trying to write a number down and even writing big, had a helluva time deciphering it. It wasn't even so much blurry, as... well, hard to describe. But not good! Turned out that 400 mg was fine. But taking it all at once was not. As soon as it was split into am and pm doses of 200mg doses each, everything was fine. Something to keep in mind if she's got you taking it all at once and it causes trouble.

Originally Posted by bluemountains

...My pdoc had me increase my dosage of lamictal very slowly, and I thought this was protocol for this drug. Also, she will only change one drug at a time...

It *is* the protocol, but I think that's just for for the initial ramp up. After you've been past the titration stage for awhile, I think bigger jumps aren't unusual. At least that's been my experience.
Mine wouldn't do more than one change at a time either. It's never made sense to me to change more than one variable at a time then expect to figure out if/what is working(!)

Sorry you had such a bad experience, tnlibrarian! Definitely call. Hope you can get it sorted out and start feeling better very soon.

[hamster-bamster]

As far as I know, there is absolutely no benefit in increasing Lamictal beyond 200 mg.

[Clinte89]

My pdoc told me 200-300 was a therapeutic level and beyond that was excess but I course it changes from pdoc to pdoc. It sounds like such a big change and its causeig trouble and then only advice ican give is call your pdoc ASAP and maybe at least split it up a little so that it doesn't cause such a shock to your system. Good luck

[Blue Poppy]

For lamictal, my pdoc never increased it by more than 25 mg at a time. You do need to increase it slowly because of the potential for a serious, fatal rash. Something doesn't sound right about going from 200 to 400..............

[Moreta]

I'm on Lamictal and Geodon. I think I went to from 200 mg to 400mg of Lamictal by taking 300 mg a week, the right to 400 mg. It's probably the Geodon causing you the problems, or the fact that you came off seroquel cold turkey. I know when I stopped my meds 2 years ago, it was horrible. 40 mg of Geodon is a small dose. Make sure though that you don't increase the Geodon too fast. It can cause a seizure. It happened to me like 4 years ago, when my pdoc raised it from 80 mg to 160 mg (got rid of that pdoc). This time around I went very slowly and didn't have a problem.