what happens when you miss doses of Lamictal?

So I've been feeling really bad today with my stomach (diarrhea and nausea) and just general lethargy. H says he can hardly talk to me; I jump topic to topic.

I looked at my meds. OMG. I am prescribed to take Lamictal (well, the generic, lamotrigine) 200 mg 2 times a day. Maybe on Sunday I took it twice? Not sure, I refilled the meds that day. I looked at the meds for this week. I am supposed to take 1 lamotrigine 200 mg in the morning, one at bedtime. Since Monday morning (I think), I have only been taking lamotrigine at night if the rest of the week's worth of my pill box is to be believed. I have it there at the night dose but not the morning for all the rest of the week. I think I have only been taking it at night Monday, Tuesday, and then I did not take it this morning, but it's closer to the night dose, so I'm just going to wait that out.

So what happens when you start to miss Lamictal doses this way? Is it stomach issues, jumping topic to topic, racing thoughts, talking a million miles an hour? I have not skipped it entirely (have taken the night doses).
Do I need to bother pdoc or just put the missing morning doses in the pillbox for the rest of the week (that is what I'm leaning toward)?

It is super frustrating. If I have to get the lamotrigine from mail order, it is an oval pink/peach type pill. If I get it from my regular pharmacy, it is usually a blue pentagon shape pill, or sometimes a giant white circle tablet. OMG, can't they make it look the same? I think this is where I got messed up refilling. I had to switch from one version of the pill to the other, back to the giant circles, and I was thinking they were melatonin (which pdoc has me on, it is a largish white tablet, not as big as the lamotrigine though) and didn't put them in the morning doses because my brain thought they were melatonin and only for bedtime.

Ugh! Does this mean I'm going to be messed up a few days now until I get taking my meds as prescribed?

I can't believe I thought this med didn't do a thing for me. Obviously, it must have helped with the racing thoughts/talking a million miles an hour, I guess sort of manicky symptoms.

Just what does a mood stabilizer do exactly anyway?

I'm certainly no doctor, but from what I gather, Lamictal is cumulative in your system, and if you were to start taking the full dose from what you were taking right now, that could be a little risky without titrating back up.

In addition to that, the side effects of being on a lower dose can vary from person to person I think. Again, I'm talking out of thin air. I have no idea.

To answer your last question, think of your lows as a floor and your highs as a ceiling. The mood stabilizers raise the floors and lower the ceilings respectively so you ideally won't cycle as frequently or as intensely. The nitty gritty pharmacological details are beyond me but that's the gist of it, to my knowledge.

I know if you miss 3 days you have to start over from scratch.

Call your pharmacist he/she can help you get back on track as they understand the half life’s.

It's all about the half life.

I'm not sure about Lamictal this way, but with other meds I've missed doses on I can get withdrawal symptoms (feeling nauseous, headache, etc) and maybe have some bipolar symptoms flare up. I would for sure call the pharmacist, or your psychiatrist, if I were you and ask how you should taper up to the dose you're supposed to take.

Mood stabilizers in general are supposed to keep the depression and mania bits at bay, at least keep them from getting so severe you can't function/wind up in the hospital.

Shrink told me "if you miss one day, take the next day, if you miss two days take it the next day, if you miss three days, find another shrink".

Cheers.

It doesn't sound too serious missing just half a dose for 2 or 3 days, but do not put the missing morning pills in with your other pills if you mean taking 600mg on any days at all.

I've never had any side effects from missing 1 or 2 doses of Lamictal (at 200mg a dose).

If you've been missing only the morning doses but are still taking it at night, you might be ok to just resume taking as normal. But please double check with your pdoc or a pharmacist.

When I took Lamictal and missed doses, I'd always get this funky "static brain" feeling. Every time I missed it. I always knew. That's one of the only meds I've had instant withdrawal symptoms on if I missed a dose.

When I was on it, I occasionally missed doses a couple of days in a row. I was on 300mg once per day.

I didn't notice anything when I missed my doses.

Since it was less than 3 days, I just resumed taking it again. Never had any issues.

Oh, no. I definitely did not take 600 mg daily. My daily dose is 400 mg, 200 mg in the AM, 200 mg in the PM. I have just resumed the pills as normal starting last night. Yesterday, I seemed a bit manicky. I was nauseous & had stomach issues that may or may not have been related to the skipped Lamictal. I think maybe they were not. My stomach is still off, but I can eat and drink now, just don't have much appetite. I did skip the running today though I went to the store to buy & ham & rolls for Thanksgiving.

I feel a bit more settled today, not as anxious. I slept in, probably a total of 9.5 hr. of sleep last night. Still feel a bit manicky, just not as much. The pharmacy is closed today, so I cannot ask the pharmacist. I am just going to resume the doses as normal, and if I feel wonky on Monday, I will call the pdoc (or I'll call his cell over the weekend if it's really bad).

The 3 day rule is exactly what my pdoc told me also. She also told me that if I am running out and won't be able to get the refill before missing a couple of days, it's better to space it out and only skip one day at a time.

OMG, I actually cleaned today, not the easiest area either, the back of our closet with the seasonal shoes that always gets super dusty. Then, I dusted and vacuumed the whole master bedroom. For some reason, the master bedroom gets much dustier than other rooms of the house, not sure why. It doesn't have more electronics or anything, and generally, we spend more time in the family room. So much dust. It looks really good now

Then, I did a quick vacuum of the rest of the house (pretty tired by then). Not great, but better than it was. 2. 5 hr. cleaning constantly is not much difference from the exercise I do in the morning anyway. Not sure where the motivation canw from...hypomania? But I had plenty of sleep, so IDK. It rarely hits me and I hate to stop when it does because I never know when it will be back. If I could get off one lamotrigine and just have the energy and motivation as a consequence, I'd do it in a heartbeat, but I think I'd also end up with the reckless driving, more racing thoughts, spending sprees, hypergraphia everywhere (I mean, it literally covered the house in notes on paper, post-its, spirals, it was freaky).

I doubt your ability to get things done has anything to do with a couple missed doses spread out over a few days due to the half life of Lamictal in general.

Just enjoy that you were able to focus and put your energy into cleaning instead of over exercising.

Good for you !!!!! Maybe you are finally turning the corner.

That would be awesome! I did have a 6 month period like that about 1.5 years ago. I got a lot of stuff organized (and then quickly unorganized when BP destabilized). It almost felt as good as hypomania, but I actually did sleep a normal amount and while I did more stuff, it was not over-the-top, like joining a book club or cooking a new recipe. It ended shortly after Harvey hit. I'm not sure if it would have gone on longer but for Harvey. We had no damage, but evacuated and had no clue how things were going in our neighborhood, though we live in the innermost part of our town (you can easily discern the old part of my town is along the ocean). But I got the constant tornado alerts on my cell phone, news of inches & inches of rain, and the news station was showing awful flooding all around where we live, and Houston was just a disaster. We got home to no damage, but IDK, I think the situational issue just ended my good spell on that front because I was so worried while we were evacuated, very anxious all the time, and panicky too.

If i miss a dose, I can't sleep that night. But i don't think that's a common thing if a dose is missed. I take 400 mg every morning.