Lamictal+BloodLevel+SideEffects+Birth Control Pill

My 13 yr old daughter had an ovarian cyst and had ovary removed 6/08. To prevent ovulation in the other one she was put on LoestrinFE24. Last month she had her fist seizure, generalized tonic clonic. EEG was abnormal so she is now on 50mg of Lamictal 2x day. Pediatrician checked out the combination and said that the pill made the Lamictal process more quickly and she might have to take a higher dose to get the desired level and that would be determined by blood tests for level. She has been taking the Lamictal for two weeks and we've notice she is more crabby than her normal 13 year old crabby. She even commented on it and said she is reactive and impulsive. Today I talked to the neurologist who said the Lamictal is given for people with mood disorders so she doubted the Lamictal was causing the crabbiness. When I asked her about blood level checks her response was that Lamictal is very safe and no blood tests are necessary. Now I'm confused. Suggestions? Thoughts?

[Dr Santos]

Hi,

The most commonly observed side effects seen in association with lamictal are dizziness, ataxia, somnolence, headache, blurred vision, nausea, vomiting, and rash. The possibility of decreased contraceptive efficacy in some patients is also considered. Dosage adjustments will be necessary for most patients receiving estrogen-containing oral contraceptive preparations. The crabbiness may be due to the hormonal changes as a result of the birth control pills. Talk to your doctor about this and ask plenty of questions to ease your worries and confusion. They are there to help and in the best position to answer your queries with their knowledge of your daughter's medical history.

Take care and keep us posted.