Re: Starting dose for Lamictal?


New Member
My 19 year old son was diagnosis bipolar three years ago, and was put on Lamictal. He did very well on the medication, but quit taking it once he became an "adult." I finally convinced him to give it another six month trial, so he went to our family doctor yesterday to get started back on it.

Family doctor started him on 100 mg twice daily. When he was on it before, we were told you had to start low and increase slowly (he started on 25 mg then). I called family doctor's office today, and was told by nurse that the dosage wasn't a mistake; that's how he's supposed to take it.

Has anyone heard of starting this medication at such a high dose? My son has had allergic reactions to drugs before (penicillin), so I'm really reluctant to start him on this dose (though he really needs to be on something for all our sakes). I'm considering getting a pill splitter so he can start at a lower dose.
My daughters psychiatrist started her on 25 mg and gradually increased the dose by 25 until she reached her current dose of 300 mgs per day.. Subsequent reading on the matter has also indicated that that is the usual procedure with lamectal. My daughters new psychiatric wants to increase her dosage but is still gradually doing so by increasing it 50mgs every two weeks. Perhaps your family Dr feels it is okay to start your son out on a higher dose since he did not have any reactions to the medication previously. If you are not comfortable with your family Dr's scrpt maybe you should consider consulting a psychiatrist or ask him why he is ordering the current dosage when everything you've read indicates a lower dosage.


New Member
hi and welcome............

we are also starting lamictal tonight actually. i was given 25mg for my daughter, yet im starting at 14mg and cutting it in half. the reason being because of all the warnings and risk of rash. this way if rash shows up can pull medication fast without having to ween down in anyway.

good luck medication game is always hard. we can't tell you obviously yet i've decided to cut it in half


New Member
Was that was the dose your son was on in the past when he d/c the medication?

Normally, with a patient naive to Lamictal, there's a starter kit that has the step up dosing already set up in blister pack format
with the recommended increases in dosing.

I do not believe in having family doctor's prescribe psychiatric medications based on some very bad personal experiences but if that was the only way to get him started on medications quickly then that's what you had to work with. I'd see if you can get him in to a psychiatrist asap and in the meantime break the tablets into quarters and start him at the 25 mg dosing recommended by the manufacturer. Or you could wait til tomorrow and call the doctor's office and request that the doctor prescribe the starter pack. Or you can ask the pharmacy to contact the doctor's office for you.

I am not a doctor but I think your concerns are not unreasonable.

The rash problem is very rare but any rash in someone on Lamictal is potentially concerning.

All that said, I am on 400 mg Lamictal daily - the maximum dose. I was on Depakote when I started Lamictal so my psychiatrist rxd the special starter kit for transitioning from depakote to lamictal. Once I was at 200 mg we increased by dose to 250 then 300 and then in one step up to 400 mg (100 mg increase).



New Member
Yeah, I would definitely want to start a bit more slowly even if he has tolerated it before. We started very low with my children.


My daughter was just switched to Lamactil from Trileptal and we started off with 25mg for 1 week, 50mg for 2 weeks, 75 mg for 3 weeks, then she is to have her levels checked and we are eventually going to be at 100mg. She takes her medications at bedtime. I would definetly start out slow and work up!