New meds

[sjconner]

I saw the neurologist again yesterday. The topiramate isn't helping my seizures or migraines. He is changing my meds from topiramate to lamotrigine. I will start titrating up the lamotrigine today and drop the topiramate next week. To make things really interesting I have my follow up colonoscopy for colon cancer next week.

What should I look for with the lamotrigine? Rash?

Thanks,
Susan

 

[Nakamova]

You might want to ask about a slower taper of the topirimate, to minimize withdrawal side effects.

With Lamictal, there are two kinds of rash that can happen if you ramp up too quickly and/or have an allergic reaction. One kind of rash is very rare but very serious, so to be on the safe side, call your doc immediately if anything that looks like a rash develops.

Aside from that, everyone has different experiences with side effects. For the first few months Lamictal made me extra-perky and focused -- which was fine during the day, but not at night when it caused vivid nightmares and very poor sleep in general. (I also experienced hair loss, though that could have been a delayed reaction to the prior med I was on). Those side effects faded; the ones that endure are dry mouth, dry eyes and blurry vision (particularly at night).

The link below shows CWE threads tagged with "Lamictal":
http://www.coping-with-epilepsy.com/forums/tags/lamictal.html

 

[qtowngirl]

hi susan,
i agree fully with nakamova, go down slower on the topiramate. just like you, i switched from topamax to lamotrigine, but the tapering was a lot slower, 8 weeks actually. depends what dose you're on however, i was taking 200 2x.
on lamot. i developed a rash the first 24 hours. my pharmacist and epileptologist couldn't believe it, the pharm. had never seen it before. my arms, belly and chest were red, i had patches on my face and my lips and eyelids swelled a bit. went off right away until it disappeared, then started again 3 days later at the half dose, 12.5mgs 2x. i've never heard of a doc starting lamot out at any more than 25 2x, so hopefully that's what you're doing as well.
let your doc know asap if you develop redness so they can go from there. BUT, don't let it freak you out too much, it can be dealt with quickly.

i'm with nak on the hair too, messed mine up pretty good, losing it and major knots all the time no matter how much conditioner. other than that no problems, been on it 1.5 years and it's just the hair at this point. good luck and keep us posted

 

[sjconner]

I currently take Topamax 25mg twice a day. I was at a higher dosage but the the neuro didn't like all the side effects and he lowered it to my current level. He predicted that it wouldn't control my partials at such a low dose but wanted to try it. I start the Lamotrigine at 25mg once a day for the first two weeks.

They are scored and I have a pill cutter ... should I halve them and take half at night and half in the morning?

 

[Nakamova]

It may not be necessary -- but if it's easy for you to do the split dose it can't hurt.

 

[qtowngirl]

honestly it depends on your prescription. from my experience when you start a med it's 'once a day' for a week, two weeks, whatever your titration is. so, if they're 25mg pills and your doseage is once a day, no.
when your doc prescibed them it should have been clear, usually with a schedule, how to start out. ex: 25mg 1x pm, 25mg 2x and on...
i am always in agreement with nak, but on this i have to say follow exactly what was set up with your doc. that being said, sometimes you can ask to cx their decision of am or pm if you want better seizure control in a certain time frame, and sometimes they'll say ok, sometimes not, depends on your doc and seizure type/severity.
if you don't have a set med schedule with this new prescription i'd call your clinic and get them to write one up.

and now i get it about the topomax, that is a very low dose, may not be an issue going off within a week.

 

[sjconner]

Thanks for the input. I am titrating up to 100mg per day over a 9 week period. I was originally planning on adding the single 25mg dose of lomatrigine at night (for the first 2 weeks). At week 3 I am supposed to take two 25 mg tablets; I was going to add the second tablet in the morning.

This is my first med swap. I really like my neuro. He listens well and seems to be looking out for my best interests even when I am not even sure what they are.

 

[petero]

it's obvious to some, but for the sake of safety I want to emphasize and encourage you listen to your neurologist and just take anything discussed online here (and pretty much discussed online anywhere ) as something to consider and to bring up with your neurologist before starting any procedures on your own.

I've acted on my own before (stupid) but it was to just titrate off of two things I found to have been prescribed under questionable circumstances and something that I was not having a beneficial effect from...
maybe the effects took longer to become active in my system... but
do as I say not as I do - lol