my psych doc told me that the depakote that i take doubles my lamictal.......can you tell me why? thanks, pat 500 mg. depakote and 25 mg lamictal.

[CamW]

fayerody - Your doctor is correct, as Depakote (Elavil-CDN - divalproex) increases blood levels of Lamictal (lamotrigine) by 200%. This is due to Depakote decreasing the clearance (elimination from the body) of Lamictal. I am not absolutely sure of the mechanism underlying this effect, and I couldn't find a reasonable explanation in the literature. The decrease in clearance of the Lamictal causes it to build up in the bloodstream. This, in effect, increases the half-life (the amount of time it takes for half of an ingested dose of a drug to be inactivated &/or excreted from the body) of Lamictal from approximately 25 hours to 50 hours.

Sorry that I cannot be more specific on the mechanism of action, but the doubling of half-life of Lamictal by Depakote is well documented. - Cam

Thanks, Cam...I research and read and I always want to know exactly how my meds interact. I really like my psych doc but her time with me is about 10 minutes, so I don't get to ask many questions. I suspect that you explained it more fully than she could have had time for. I'm going to start nursing school in August so it's really cool to learn these things.

Another question, actually...what is the difference in the make up of say an anti-biotic staph infection with a run of the mill bacteria....when i worked in ER, a man came in with MRSA and the surgeons actually had to remove part of his hand to rid him of the infection.....Thanks, Pat

[CamW]

fayerody - You just left my field of expertise. I am a community pharmacist who has never worked in a hospital. My knowledge of microbiology is antiquated, at best. I have never had any exposure to MRSA (thank goodness). All I know is is that MSRA has evolved mechanisms to inactivate every antibiotic that we had, or even are able to develeop (although I heard that some researchers are finding ways around the MRSA's defenses).

Sorry, I just a drug guy, I only fill the prescriptions. My knowledge of psychopharmacology is my strong suit, little else. - Cam

that's okay, Cam....i'm totally impressed by mrsa..and scared to death of it also...from your perspective, do you think that antibiotics are prescribed too often?

[CamW]

fayerody - Yup, after 20 years of knowing better, doctors still over-prescribe antibiotics all of the time. It is a symptom of our society; people are programmed by T.V. commercials that if you have a cold, it needs to be treated with medication. A cold is going to last 7 to 10 days, no matter what you take for it. The cop out that by giving antibiotics you are preventing opportunistic bacterial infections because the cold virus has weakened your immune system is just plain illogical and wrong. Drink lots of water, and rest as much as possible; that's the best that can be done.

Oh, and don't get me started on Cold FX!..... - Cam

we're on the same page...in ER, everyone that had the sniffles came in for "antibiotics".....there was one doc there that would not prescribe them wholesale.......and don't even get me started on growth hormines for cattle, pigs, sheep, chickens, ducks, geese......... it's no wonder people are so bleeping sick and don't know why..........