Lamictal for Bipolar

[Let_Me_Stand]

Med: Lamictal 50mg 2/day for almost a year and thought I was back in the "normal" world, had setback and doubled lamictal to 100mg 2/day.  Rashes started and he added cymbalta wich helped the hives then.

Current symptoms:  Hives on arms and on my face.
Current gross symptoms:     Sores unbelievabley pop up in mouth, the skin tags on bottom of tounge then on top, then sores travelled to throat (HURT).  Was missed diagnosed with 4 doses of Nystatyn and 3 biopsies later, it is not thrush, I've never had anything like that.  Eyes extremely dry and hurt.  Speach impediment, my words get twisted up and I uesd to be intelligent but feel can't even carry on conversation, lose thought process in middle of sentence, now, sores have moved to outside my mouth.  7 yes 7 blisters I just woke up with running from my mouth, now (has happened 3 times now), running lowgrade fever off and on, worst symptom is all the blisters in my throat, tounge swelling.  Rash on my face that is very dry and getting worse.  No body seems to know because each doctor treats their specialty.  (Before Lamictal though, tried many depression meds and all I needed was mood stablizer once I found Lamictal and got off of 5 other meds, had been normal - don't cry uncontrobially and am dealing with life situations but before Lamictal, I tried suicide twice 1st self inflicted gunshot just from impulse)

Solution (NOT) - was told to go to ER by doc and do a lamictal blood level test.  After waiting 6 misreable hours, they say they cannot run that kind of test but my liver was OK.  Was sent home.  No diagnosis

[Tink70]

Per the PDR: SERIOUS RASHES REQUIRING HOSPITALIZATION AND DISCONTINUATION OF TREATMENT HAVE BEEN REPORTED IN ASSOCIATION WITH THE USE OF LAMICTAL, THE INCIDENCE OF THESE RASHES, WHICH HAVE INCLUDED STEVENS-JOHNSON SYNDROME, IS APPROXIMATELY 8 PER 1,000............ Per PDR: CONTRAINDICATIONS: Adult Population:  Serious rash associated with hospitalization and dicontinuation of LAMICTAL......Among the rashes leading to hospitalization were Stevens-Johnson syndrome, toxic epidermal necrolysis, angioedema, and a rash associated with a variable number of the following syustemic manifestations: fever, lymphadenopathy, facial swelling, hematologic, and hepatologic abnormalities.  There is evidence that the inclusion of valproate in a multidrug regimen increases the risk of serious, potentially lifethreatening rash in adults.........
RUN, DO NOT WALK to your doctor.  The ER doc was an idiot.  Find another one, and quick!  This is NOT normal.

[ames67]

Agree with above GET TO DOCTOR ASAP. CAll your psychiatrist immediately I think the rash can be fatal if left untreated. KEEP us posted please!!!

[jen21287]

Get to your pdoc pronto! That rash is life-threatening and is most definitely caused by the Lamictal since you just doubled your dose. Lamictal increases are supposed to be VERY gradual. I am sorry you have to deal with this especially considering how well the Lamictal was working for you before.

[Let_Me_Stand]

This is my first reply to a post so hope I don't send to the wrong place.

Thank you for your help and the info.  The doc (whew) worked me in and saw for himself symptoms of above and they confirmed the double dosage date as well as saw my now skally rash on my face and all the blisters that have dried up on the outside that have began to heal.  Also the whatever it is under my tongue was very red and swollen.    

He said not to go to the ER at all unless tongue is totally swollen where I can't breathe and that't it, and, that Lamictal would not cause the dry eyes or blisters down my throat or the muscle pain and fever.  He did talk to my husband in doctor terminology, all I remember besides the 2nd opinion was SJS and some other Switzerlin (sp?) name that started with an SJ...then, turned to my husband and said that lamicital was bad for causing this (I'll have to ask my husband whatever else he called it), for causing this SJ syndrome and believes that is what it is but wants 2nd opion and won't change any lamictal dosage until psychiatrist agrees with him because the lamictal has saved my life for a long time.  

But, I'll do whatever it takes.  Sometimes I just want to jump and down on my couch and scream or get under the covers and stay there for 3 days.  Needless to say I'm upset with this all timed out medicine and additional doctor again.  I need to just put my life story on a recorder and save a lot of breath.

OK, I'm taking a deep breath and just holding on for today and tomorrow will take care of itself     'cuz I'm too tired to understand what all this means so, I'll say goodbye for now and thank YOU for your help.  I would like to help people one day too.  This seems to be a nice place to lean on.  :o)  

[Nikki2226]

I just got diagnosed with bipolar and the doc put me on lamictal.  This is scaring me. Like , raelly scaring me.  I have only taken one dose so far.  Is there a medicine with less side efffects I could ask the doc about?

[xanweaner]

Please....did you contact your psychiatrist yourself by phone? You need to do so right away. I'm assuming that the physician that you saw is not your psychiatrist?
This could be quite serious and needs to be addressed right away.

I'm sorry that you are suffering so much, but please do not wait any longer to call your psychiatrist.
Good luck...

[jen21287]

I do not intend on scaring you but thought I should pass this info on to you. SJS is Stevens-Johnson Syndrome. Lamictal can cause it even after months of taking it and it does cause a fever.

http://bipolar.about.com/od/glossarys/g/gl_sjsyndrome.htm

[DLA]

So can you tell us exactly why he didn't think this was serious?  SJS is the deadly rash associated with taking Lamictal.  

[stlfoleys]

Hi Nikki,
I don't think you need to be as scared as you may be right now.  I've been on Lamictal for over a year, with no side effects and excellent results.   I was scared at first.   This was the 1st medication that I took for bi-polar (vs other depression meds) but I was really happy with the results.   Obviously there are some side effects that you should watch out for, but the odds are strongly in your favor that you wont have any of them.  And the starter packs that they give you are a way of slowly working up on it to make sure your body is taking it without problems.   Hope it works for you too!

[Let_Me_Stand]

Sorry it's taken so long to reply: several excuses i guess:  
1. trying to get help: tried to get cronic pain doc to refer me to psy that takes my ins.
2. my psychologist trying to get me in with a psychiatrist that will take my ins. as well.
     (i feel like a tossed girl in the bubble about now)
3.  I had been doing so well on the lamictal and cymbalta that I thought I had no need for psychiatrist for the last 10 months or so.  Now, bam, I need one and who wants to start with a patient that already has SJS.  When I had dbl couverage insurance I could get in anywhere.  (least of problems)
4. I've seen, neurologist, internal med. doc, pain clinic, GI specialist, Eye doctor

I LEAVING MESSAGES DESPERIATELY WITH PSYCHIATRIST AS WELL AS 2 OTHER DOCTORS TRYING TO GET ME IN WITH THEIR REFERRALS.

Have you guys ever heard of cronic soreness of muscles and even bones all over?  Also, I'm having to wear a brace on my right wrist because it's gotten so sore that I can't tell if it's carpul tunnell *sp*  or arthritis or what?  Now, I've fallen again with my right ankle buckeling and hitting the concrete.  

I mean I felt ditzy before but this is uncontrollable.  I have to laugh instead of crying.  

The strangest thing of all that I don't understand either is that it comes and goes anytime it wants.  The only thing I know for sure, is I take my Lamictal by itself before my other meds.  (seperating times of each might help reveal something) and it did.  I get up and my speach is fine, and my thoughts/process is fine.  I can sit and read.  However, 20 minutes after lamictal, my speach gets disleslick (can't spell on here) and I have trouble concentrating.  Get this, someone close to my family passed away last week and before taking lamictal i was balling  boo hooing all times, emotions were crazy.  Finally took my lamictal, 20 minutes later I was still sad and upset but not one tear.  I don't mean to be unsympathetic to the family but everything dries up and I don't lose control of emotions.  Have you ever had that love/hate relationship with you medicine that can cure you but can kill you at the same time?  

OK now I need to pay somebody for this psychology visit.  Haven't had a bad breakout in two weeks.  I hope and pray that I'll have an answer soon.

Thank you.  I'm trying my best to get the right psychiatrist.  Maybe have to go to Vanderbuilt, TN or somewhere besides here.  

How are the rest of you?

And how do I reply to someone else's comment without having to type in their screen name?

[DLA]

I do not understand if you have SJS why they still have you on the Lactimal.  Can you help me here?  You should not be taking this medicine any more!!!!!  This is a FATAL disease and the first thing you are suppose to do is STOP THE MEDICINE that is causing this!  Am going to send you a website to look into that explains all of this and why you ARE NOT suppose to still be taking this drug!

[Enoch Choi, MD]

Hi from a family doc who's practiced emergency medicine for a decade

Since you can't get through to your psychiatrist, follow the instructions that you've received from your doctors so far

"He said not to go to the ER at all unless tongue is totally swollen where I can't breathe"  -- this is because a life threatening reaction would occur if swollen airways block your ability to breathe, which can happen from allergic reactions to medications but had not happened in your case since you were sent home from the ER.

Any medication can have side effects, including itchy rash.  A physician in the ER would try to determine a rash was due to a medication then advise on stopping or continuing.

I'd follow the ER physician's recommendations on continuing or stopping the Lamictal

If worse, go back to a different ER.