changing medications monday

[Jena]

hi

met with pyschdoc today, got script for lamictal.... 25mg once a day than after a week if no side effects twice a day at 25mg.

hoping it lifts her from her depression. doctor wanted to keep her on 5mg of zyprexa. he's afraid the eating disorder will relapse.. i didnt' want to keep it, it's serving zero purpose right now. yet that fear he verbalized was well enough to make me agree.

than hopefully once lamictal agrees with-her we'll add in an ssri to stop the obsessing than maybe that'll be the combo she needs with-the intensive therapy to finally make a difference.

here's hoping. i've never ever had her on more than one medication at a time....hoping i'm doing the right thing time will tell

 

[HaoZi]

Here's to hoping for the best!

 

[pepperidge]

Jena,

My experience with Lamictal (combined with other medications, though not starting at the same time) has been great for one, didn't help the other. We chose to titrate up slowly---more slowly than recommended because of rash issues. One of my children did develop rash, no idea if it was the rash (we were on vacation) so we d/c drug immediately per doctor's orders with no problem. Then we tried it again with slower titration, no problems. So whatever the rash was may have had absolutely nothing to do with drug.

It does take time to titrate up -- however, the child that it helped we saw improvements in even before we got to therapeutic dose. It helped alot with irritability and depression. He wasn't at manic though. And risperdal seems to help more with anxiety etc for him. So it may be good to keep on Zyprexa for a while until you get the Lamictal dialed in and figure out if it is helping. You don't want to pull the Zyprexa and be trying to figure out what the Lamictal is doing at the same time. The Zyprexa may be doing more than you realize--even if it falls way short of what you want to have happen.

On clinginess, one of my difficult children had strong separation anxiety type issues. In part they interfered strongly with his school work even in a very supportive setting in public schools. He just wanted to stay home all the time. It wasn't until he tanked and we were forced to get him into an wilderness and then Residential Treatment Center (RTC) type setting that he was forced to deal with the separation issues. It was difficult, but he is now showing much more confidence in social situations and ability to survive on his own. (This happened at 15, however). It is so hard when they are home because it is hard as a parent to see them suffer and not want to protect them to some degree--and hard to sever the apron strings on the parent's end as well.
Good luck.

 

[Jena]

thanks guys we'll see how it goes. she's gotta lift out of the depression first, she's down there bad. than if that medication works, and i'm really hoping it does next is adding in the ssri and dropping the zyprexa. we just can't get her to fully adhere to this expensive cbt we're doing weekly.

 

[smallworld]

Your doctor is titrating Lamictal more quickly than is recommended by the manufacturer. It is recommended for adults that Lamictal be started at 25 mg for two weeks, then increased to 50 mg for two weeks and so forth. The titration schedule is deliberately slow to avoid the risk of the serious Stevens-Johnson rash.

I agree with Pepper that Zyprexa may be doing more than you realize. We didn't realize how much it was doing until we tried to get my daughter off of it and she completely fell apart. Just a thought.

 

[DammitJanet]

I agree with SW on the dosing. Why didnt he give you a starter pack? I would insist on the starter pack. Your doctor has that as a sample in his office. I know that for a fact. Every psychiatrist does. The manufacturer keeps them inundated with those so they can start patients on that medication in a timely manner. I cant tell you how many starter packs I have had. Its an orange cardboard folder with 4 folds if I remember correctly. Weeks one and two on the first one, 3 and 4 on the next, then 5 and 6 and then 7 and 8 on the last. I believe that takes you up to 200 mgs a day.

 

[smallworld]

And I will add that because we were dealing with children when we started Lamictal, we titrated even more slowly than the manufacturer recommended. We started at 12.5 mg and went up in 12.5 mg increments every two weeks. Our kids had zero side effects.

 

[pepperidge]

We also used the starter packs, but went up at half the recommended dose as SW mentions. The psychiatrist as I remember thought it would be a good thing to go slower. I would definitely make sure you aren't increasing it faster than you would with the starter packs.

 

[Jena]

great info thank u! he said start at 25mg i'll start at 12.5. also she currently has a huge rash on leg. i was thinking maybe i should head to dr to get craem for it before i begin this. so that i can tell if there is a rash from medication or its existing rash getting worse? it would back up our start date yet whats the rush right?

 

[cubsgirl]

I think it's good to go slow with Lamictal.

However, I would at least notify the psychiatrist who prescribed it to let him/her know that you are more comfortable starting with 12.5mg instead of 25 so psychiatrist knows all that is going on with the initial dosing.

I agree if you can get a starter pack that would be great!

Hang in there.