Lamotrigine - Long term effects

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I found this statement interesting:

Lamotrigine binds to melanin-containing tissues such as the iris of the eye, but the long-term effects of this binding and accumulation are unknown.

http://www.aafp.org/afp/980201ap/curry.html

Hey, Melanin is in nerve tissues. If lamictal binds to melanin, then what will it do to our nerve tissues long-term, good or bad?

http://www.i2k.com/~suzanne/ZINC melanin, tissue repair, brain fuction-page 5.pdf

*Zinc is the main element found bound to melanin, (a dark brown substance) in pigmented cells and tissues of the skin, hair, parts of the eye, and certain nerve cells. Melanin is synthesized and stored inside melanosomes (specialized organelles also referred to as melanin granules) of melanocytes that are located in the epidermis and connective tissue of the skin (Borovansky J,1994). Melanocytes transport melanin granules to parts of the eye and ear, and to certain nerve cells of the brain

Okay, let's all put on our science hats:

The neuron also contains inclusion bodies, which have variable distribution in the nervous system, e.g.: Melanin pigments (Neuromelanin) are found in the substantia nigra of the midbrain and locus coeruleus of the pons in the brainstem
http://sta.uwi.edu/fms/MDSC1001/THENERVOUSTISSUE.pdf

Okay, if Lamictal binds to Melanin in nervous system tissue, is it:
a) long term or permanant?
b) good, bad, or mixed?
c) what diseases or nervous functions would it affect?

I'm guessing nobody knows at this point.
 
My theory: I think that the melanin-binding aspect of Lamictal affects vision because plays a big role in how sharply we see things (in addition to being responsible for the color of our eyes).

Melanin mops up the light that has passed through the retina, keeping it from being reflected back and scattering around inside the eye; it has the same function as the black paint inside a camera. The melanin-containing cells also help chemically restore the light-sensitive visual pigment in the receptors after it has been bleached by light.

Melanin reduces the amount of light entering our eyes and improves their image-forming ability (similar to the way that "stopping down" the iris diaphragm of a camera does).

If melanin is bound that means it's not available to do its usual tasks -- including those related to our ability to focus.
 
I think all of the drugs have side effect and that is according to the person taking them, we all react diffently.
I really don't like this process of elelimination, but that is just how it is.
I have to remember to be thankful for the medic.
I too wish I didn't to take my med.
 
My theory: I think that the melanin-binding aspect of Lamictal affects vision because plays a big role in how sharply we see things (in addition to being responsible for the color of our eyes).



Melanin reduces the amount of light entering our eyes and improves their image-forming ability (similar to the way that "stopping down" the iris diaphragm of a camera does).

If melanin is bound that means it's not available to do its usual tasks -- including those related to our ability to focus.

Is keppra somehow related to melanin as well?

I know that everything is brighter since i've started taking it to a point where my eyes hurt and i can't focus on something that is far away (i know who is there but i can't see him as clear as someone who is close to me) and it was like this even on a small dose as 500 mg a day.Din't really chagne after increase.
 
Keppra doesn't bind to melanin -- but it's not known exactly how it works in the brain, so it could potentially cause vision side effects by a different process.
 
I have been on Lamictal for 14yrs., 600mg a day. which my doctors have told me is alot. It has controled my seizures for the most part. As long as I stay away from my triggers. My worry is...can the lamictal damage my organs (liver,kidney's ect.) If tyenol can damage you then what can it do? I started with peti mals, then to grand ma's, then going seizure free for over 3 yrs, 5 years before that to now having absences and myoclonic seizures(new nero is still running test to see whats up). so should I be worried?
 
There are very rare cases where Lamictal can cause multi-organ failure, but that's a hypersensitivity reaction -- if you were hypersensitive, you would have started having reactions when you first went on the med.

Your dose may seem high, but keep in mind that there is no specific target therapeutic dose for Lamictal. The effective dose is what works for any given person. So while there's a suggested range, many folks achieve seizure control on either side of that range. The important thing is that you don't feel over-medicated. If you are concerned about your dose, or about your liver or kidney function, you can ask your neuro to have a blood test run just to make sure all the numbers are fine.

That said, there haven't been a ton of studies of Lamictal over the long-term. You might be interested in checking out the askapatient site, where Lamictal users post what there experience has been with the med. The site indicates how long and what dose a person has been at, so you may find patients whose situations are similar to yours. http://www.askapatient.com/viewrati...e=LAMICTAL&PerPage=60&sort=timelength&order=0

I've been on Lamictal for 4 years. The side effect that bothers me the most is the effect on my vision. It was perfect before I went on Lamictal, but as soon as I went on it my eyesight started getting blurry from time to time. I also am slightly low on my red and white blood cell count due to the Lamictal, but with no health consequences.
 
Memory issues

Do you have memory or cognitive issues on the lamotrigine? My wife says my memory is bad and that it seems like I'm not "firing on all cylinders".
 
gnault,

I have experienced memory problems and I'm also on lamotrigine. I had taken Dilantin forever and was changed to Keppra XR because of long-term side effects of Dilantin.

I'm not sure if the memory problems are from the Keppra or the lamotrigine. I was on Keppra when Vimpat was added because my seizures weren't controlled, but I couldn't tolerate the Vimpat so lamotrigine was added slowly and then I tapered off Vimpat.

Memory problems are frustrating and have affected my ability to work......no one wants to have a forgetful nurse. I know I wouldn't!
 
I haven't experienced any cognitive issues on lamotrigine (I've been on it about 7 years now). But everyone reacts differently and has a different medication and seizure history. If you suspect a med is causing cognitive problems, I recommend having a neuropsych evaluation done. It can indicate which particular areas may be having trouble, and sometimes point to a particular cause (i.e. meds vs seizures vs depression). It takes a snapshot of how your brain is doing, and can as provide a benchmark against which you can measure any future changes in cognitive function down the road. And the neuropsych can often provide strategies and workarounds to enhance memory function and other problem areas.
 
Cawhitern: We have the same diagnosis. Currently on Lamotigrine and Vimpat. Not sure if the my memory problems are due to the seizure itself or to the medications. Maybe both.
 
Cawhitern: My wife "accused" me of having early onset alzheimer's dementia. Somedays my memory is bad. We'll discuss something, even as simple as a tv show, and ten minutes later I will mention or ask her a question about the same thing as if we hadn't discussed it. She said to me yesterday that I was starting to worry her about this memory loss.
 
Cawhitern: We have the same diagnosis. Currently on Lamotigrine and Vimpat. Not sure if the my memory problems are due to the seizure itself or to the medications. Maybe both.
Sunday morning I got up and got ready to go to church. On the way to church it was showing hard enough that we turned around and went home. When I got home I changed out of my grey casual pants into jeans and went about my day. Later that night I couldn't find my wallet. I looked in my car three times, my wife's car numerous times, downstairs, everywhere. I even checked my beige pants that I thought I wore to church. We probably looked for forty minutes and then my wife checked my grey pants. There my wallet was. I couldn't remember which pants I wore a few hours ago. My wife really expressed her frustration with the memory issues and how much it is stressing her out.

I went to the store to get milk, eggs, tomato soup and maybe one more thing. I came home with two out of the four items. The main thing on the list was eggs and that was what i forgot.

Memory issues aren't fun. I mentioned it to my pharmacist and she mentioned talking to my doctor about reducing my lamotrigine as I am having shoulder joint pain as well. If hey lower that then they will likely have to add something else. Some days I fall asleep quick some nights I don't. Some nights I fall asleep quick but we up in the night and then law awake for an hour or so.

Not sure if I'm looking forward to a medication change or adjustment if things seemed to be going well except the side effects. Memory and cognitive issues are good for work either though.

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Agree with Nakamova. Discuss with your neurologist for a neuropsych evaluation. I had that when I had my Video EEG. I am on two other anti-epileptic drugs. So I don't know which one causes it. And our medications affect our memory differently from others. One thing that has helped me is to assign a specific spot for every item that I need. And do it slowly so I can focus and make a mental note. For example, my eyeglasses have to be placed on this spot of the table and nowhere else. I always empty my pockets and place the items on a designated spot. At some point I had to make a laundry list of items and posted it on my cork board. It can be frustrating but we need to have a way of dealing with it. Hope this helps you and your wife.
 
Agree with Nakamova. Discuss with your neurologist for a neuropsych evaluation. I had that when I had my Video EEG. I am on two other anti-epileptic drugs. So I don't know which one causes it. And our medications affect our memory differently from others. One thing that has helped me is to assign a specific spot for every item that I need. And do it slowly so I can focus and make a mental note. For example, my eyeglasses have to be placed on this spot of the table and nowhere else. I always empty my pockets and place the items on a designated spot. At some point I had to make a laundry list of items and posted it on my cork board. It can be frustrating but we need to have a way of dealing with it. Hope this helps you and your wife.
I work in a support role for the military in the city that I live in. The things that I do everyday as the main functions of my job I have no issues with. The short term tasks are sometimes another story. I had a discussion with one of the officers that I work with. She mentioned something that we had previously discussed and I didn't recall discussing it. I need to take notes, but often my notes aren't very good. Never a dull moment I guess, there are better ways to keep life interesting though.

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It messes up my vision whenever I increase. I was at 25mg and I just started another increase.

My typing is very poor, not sure.

I also don't think it is helping with my seizures. I don't want to admit it to the doctor because I am allergic to kepra and am worried about worse side effects from other meds.
 
Agree with Nakamova. Discuss with your neurologist for a neuropsych evaluation. I had that when I had my Video EEG. I am on two other anti-epileptic drugs. So I don't know which one causes it. And our medications affect our memory differently from others. One thing that has helped me is to assign a specific spot for every item that I need. And do it slowly so I can focus and make a mental note. For example, my eyeglasses have to be placed on this spot of the table and nowhere else. I always empty my pockets and place the items on a designated spot. At some point I had to make a laundry list of items and posted it on my cork board. It can be frustrating but we need to have a way of dealing with it. Hope this helps you and your wife.
I had another interesting day. My wife asked me to look at the December calendar and figure out what the date was for the second Tuesday of January by counting the days from the 31st. I looked at two or three timings and my brain wasn't clicking on it. My wife was surprised that I couldn't figure it out. Tonight before supper I was getting the coffee pot ready. I started putting the coffee in got it half full with no filter. I seem to have quite a few errors or mistakes that are so obvious or even simple tasks. Time to call my doctor tomorrow to talk about medication/side effect issues.

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I hope you are able to see the doc soon, and get some advice on what to do.
 
I hope you are able to see the doc soon, and get some advice on what to do.
Happy New Year!

I'm suspecting that they will likely adjust/lower my lamotrigine. If that's the case then they would likely add something else in. I was on carbamazepine for about 10 years. I lost almost thirty pounds and electrolytes and theputic levels going wacky. That's when I was switched to the lamotrigine.

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