Posted by Ron Hill on July 29, 2002, at 10:48:54
In reply to Epilim Chrono???, posted by colin wallace on July 26, 2002, at 11:35:39
Colin,
As I said earlier, if you happen to be a person that does not develop a rash (SJS or otherwise) on Lamictal, it might turn out to be a very good medication for you. Lamictal can induce mania in some bipolar patients (JohnX2, for example).
The key to taking Lamictal, as I understand it, is to "start low and go slow". In other words, begin at a very low dosage, say 25 mg/day, and ramp it up slowly. Many people who developed a rash by initially jumping up to a full strength dose have found success with Lamictal by discontinuing the medication and starting over using the "low and slow" technique. However, some think that once the rash has presented itself, the patient is much more susceptible to the rash reoccurring even when the follow-up trial is done using the low and slow method. The pdoc I was using at the time started me off at about 200 mg/day. WRONG!!!
If the rash shows up, it is difficult to get rid of. My dermatologist determined that it was not SJS and then prescribed a corticosteroid topical ointment to clear it up. It worked fairly well but the corticosteroid can only be used for about 14 days. And soon I found the rash covering more and more of my body so I took myself off of Lamictal.
Bottom line: As a preventive measure to minimize the chance of developing a rash, go low and go slow. Due some research (on this site and others) regarding the appropriate starting dosage and ramping rate. One disadvantage of Lamictal is that, if the patient is in mania, it takes awhile to bring the blood level up to the applicable therapeutic range. In cases like this, many pdocs will use Depakote to control the mania while ramping up the Lamictal. From there, some get rid of the Depakote and use Lamictal monotherapy while others use a combination of the two.
-- Ron
------------------------------------
> I have here near my keyboard ,an innocuous looking pack of epilim chrono.
> I am told that it is 'the same thing' as Depakote.I checked on the Depakote brand website, and they state that these two products are not to be confused, ie. epilim is for epilepsy only.
> I am highly dubious about popping one of these babies, even more so than before.
> Valproate monotherapy for depressive mood crashes? My instinct tells me to throw them away and order some lamictal or else maybe use them at the lowest dose (200mg) for a couple of weeks, till it arrives, and then ditch it.
> My psych. deems me fit not to be seen for another 6 months- two days ago, I was so angrily depressed (following zoloft discontinuation) I was maniacally driving at 90mph and playing traffic 'chicken', seriously considering a head-on crash.I think my psych. actually disbelieved me, or was disinterested.
> As all the meds have left my system, that memory appalls me, and I feel stable, and quite normal.
> My 'mania' is purely antidepressant induced, and was hitherto unknown.I now have to try to stave off the depression that will invariably occur.
> But epilim monotherapy??Hmmmmmmm.
> Any thoughts most welcome.
>
> Col,
poster:Ron Hill
thread:113811
URL: http://www.dr-bob.org/babble/20020725/msgs/114155.html