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Old Aug 31, 2013, 12:28 AM
awakeodin awakeodin is offline
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I'm not sure where to post this, but it concerns a common drug used for bipolar disorder (which I may have, but am not taking this for).
My new neurologist put me on Lamictal for nocturnal seizures, and gave me instructions of taking 25mg for 2 weeks, then twice daily for 2 weeks, and increase from there (from 25mg to 200mg in 6 weeks).

I was afraid to have another seizure in my sleep, as they cause me a lot of pain, so I looked up online if others have started at a higher dose, and some say they started at 100mg a day without issues.

So I stupidly and impatiently decided to bump up from 25mg to 100mg a day after taking it a day or two, then a week later (yesterday) I increased it to 150mg a day (basically skipping the first 4 weeks of my instructions in a period of a couple days, and following the increase instructions from then on of increasing another 50mg after a week being on 100mg).

I'm not sure what to do now... if anything bad that may happen would have already happened by now (like Stevens Johnsons Syndrome) from starting at 100mg instead of 25mg, then increasing to 150mg a week later.

I'm kind of weary of contacting my neurologist, as I don't want to get kicked from his supervision for doing this, and since I'm already at this level, I'm not sure going back down would be a good move either, or if I should be worried - if the odds of SSJ or any other issues are that much higher from starting at such a dose.

I think I'll go to the pharmacist and explain I was confused, and ask their experience on the medication, but I probably just have to suck it up and contact my neurologist as well, although I can't do so until the weekend's over, and even then I'm not sure how long it would take for them to get back to me.

I realize my mistake, and have to take control of this impatient irrational side of me, although now that I'm in the middle of my screw up - I would appreciate any input, thanks.
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  #2  
Old Aug 31, 2013, 01:13 AM
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dragonfly2 dragonfly2 is offline
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Oh my, that is a quick jump. I would definitely check in with your pharmacist and see what they say. I'm not sure how long it takes for the SJS rash to show up, but I would be very vigilant about watching for it. As for calling your neurologist, that probably can't be avoided at this point. As a minimum, you'll need to get a new prescription now that you're already at the higher dosage. I'm assuming you were given one of the titration packs and not prescriptions for each dosage. You'll be at the end of that pack soon and will need to have your higher dosage sooner than you normally would have.

You mentioned that you could also have bipolar. Even though Lamictal is considered a mood stabilizer, it is a very activating one and can cause mania in some people. Just be aware of that if you start to feel agitated or racy at all. That, I think, would warrant paging your doctor and getting in touch with him or whoever is on call, even over the holiday weekend.

It sounds like you've learned from your mistake. I wouldn't spend too much time beating yourself up over it. Just own up to it with your doc and move on from here.

I hope it turns out to be a good med for you.
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  #3  
Old Aug 31, 2013, 01:53 AM
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LacunaCoiler LacunaCoiler is offline
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Wow… I must say that was quite a rush in dose change. Since my pdoc put me on lamictal I have had to have blood work every two weeks as my dosage went up. Your lamicatal blood level should be between 1.5 to 15 and if it’s above 15 it can be very damaging to your liver so depending on how your body is absorbing it and breaking it down you may be pushing that level without even knowing it.

What they told me was that Stevens Johnsons Syndrome can happen anytime but if you haven’t had it in the first 6 weeks chances are in your favor of not getting it, but it can still happen so keep a vigilant eye out for it. Also, just like DragonFly2 stated, it can cause manic episodes in a bipolar patient so that’s also something to watch and monitor because that can bring a new set of problems.

I think seeing a pharmacist is a must at this point until you see your neurologist, which is unavoidable now and ASAP. If they do not know what you did then they cannot continue with your treatment correctly since they will still believe you are on the lower dosage. I believe it’s time to just own up and admit your error that way you both can work on properly treating your seizures.

Good luck and I hope it all works out for you
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  #4  
Old Aug 31, 2013, 02:07 AM
awakeodin awakeodin is offline
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Quote:
Originally Posted by Are you suffering? View Post
Wow… I must say that was quite a rush in dose change. Since my pdoc put me on lamictal I have had to have blood work every two weeks as my dosage went up. Your lamicatal blood level should be between 1.5 to 15 and if it’s above 15 it can be very damaging to your liver so depending on how your body is absorbing it and breaking it down you may be pushing that level without even knowing it.

What they told me was that Stevens Johnsons Syndrome can happen anytime but if you haven’t had it in the first 6 weeks chances are in your favor of not getting it, but it can still happen so keep a vigilant eye out for it. Also, just like DragonFly2 stated, it can cause manic episodes in a bipolar patient so that’s also something to watch and monitor because that can bring a new set of problems.

I think seeing a pharmacist is a must at this point until you see your neurologist, which is unavoidable now and ASAP. If they do not know what you did then they cannot continue with your treatment correctly since they will still believe you are on the lower dosage. I believe it’s time to just own up and admit your error that way you both can work on properly treating your seizures.

Good luck and I hope it all works out for you
Thanks for the replies. I just upped from 100mg to 150 yesterday (so I only took two extra tabs), so I'll stop doing so, and remain at 100mg until I hear otherwise from the doctor or pharmacy.
  #5  
Old Aug 31, 2013, 09:28 AM
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A Red Panda A Red Panda is offline
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There is a reason why doctors assign a prescription the way they do you know

((I know you know.. just couldn't resist saying it)).

I slowed my titration down actually. Pdoc wanted me to start at 25mg, so I decided to start at 12.5. Unfortunately have hit a roadblock as he titrated me up to 50mg and then didn't say anything else... so I've stayed at the 50mg for ages and it is toooootttalllly not doing a single thing.

But I'm still waiting for my pdoc.
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  #6  
Old Aug 31, 2013, 10:22 AM
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Speed3 Speed3 is offline
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When I was taking Lamictal, my husband was giving me my meds. He read the bottle wrong and was giving me too much.

This was a number of years ago. I did get the rash, but was seen by the dermatologist right away. I stopped the drug immediately.The rash then cleared quickly. When this happened I had been on it for a while. They told me the rash can happen at any time, you always have to be on the look out for it.
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  #7  
Old Aug 31, 2013, 11:32 AM
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Victoria'smom Victoria'smom is offline
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If it was me I'd stop the high dose immediately and start over with the tieration and watch for a rash.
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  #8  
Old Aug 31, 2013, 02:29 PM
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~Christina ~Christina is offline
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SJS is nothing to play around with the possibility of getting it. Go talk to your pharmacist.
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  #9  
Old Aug 31, 2013, 02:37 PM
Anonymous100110
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Definitely not a good move to titrate up too quickly on lamictal. Call your doc and let him know exactly what you did, then follow his directions for meds explicitly.
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