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Jmizz

Jmizz: Lamictal taper suggestions

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Altostrata

Not weird at all. That's exactly how lamotrigine affects people.

 

It is a tricky drug, probably why many doctors avoid prescribing it.

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Jmizz

@Altostrata

 

ok good. I’m hoping the fatigue over the past month or two was bc my system is calming some and the lamotrigene was actually having a dampening effect after the initial dose surge wore off. Hoping my energy will come back some if I get the daytime load down. 

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Altostrata

Fatigue is a common effect of lamotrigine. Yes, the signs all point to reducing it, carefully.

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Jmizz

@Altostrata

I dropped off the 0.25 this morning. Nighttime dose is hitting a little different tonight. Seems the queasiness is kicked up. Is this to be expected or a sign that maybe I need to wait longer?

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Altostrata

It looks like you get queasiness when your overall dosage drops. Can you chew a bit of raw ginger or drink ginger tea? That can help.

 

Sorry this is so bumpy.

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Jmizz

@Altostrata

No need for you to apologize. You are a saint for what you do, I can’t imagine not having somebody to bounce ideas and symptoms off of. Thank you from the bottom of my heart.

 

 You didn’t prescribe me the pills. I was expecting the nausea just maybe not this fast, it’s not horrible...yet. I’m going to keep a detailed list of the pattern this drop follows. I have a decent idea from reading back in my history how it should go. I just hope it doesn’t get too bad bc I still felt like I was shaking off the last drop and then portion moved to night. I need to get back to a decent spot hopefully soon and hold til after my baby is born. 

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Altostrata

Lamotrigine has a half-life of maybe 12 hours and you've shown evidence of being a fast metabolizer and quite sensitive to the drug, so you're a pretty good guinea pig for lamotrigine pharmacokinetics. 

 

When is the baby due?

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Jmizz

@Altostrata

July 12th. I’m terrified bc a month ago it seemed like I could handle it, now I’m in the middle of some huge setback.

 

so being a fast metabolizer and sensitive means it’s probably going to be tougher for me to lower my doses or did you just mean it’s easier to see the drug effects with me bc everything hits me so fast?

 

 

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Jmizz

@Altostrata

 

While I’m in sort of a little post drop honeymoon for a day or two, and thinking halfway clearly I figured I’d say this. I think I’m finally figuring out what’s going on, as I’m sure you have. I have more of an adverse reaction problem than withdrawal problem at this point. My system has calmed a great deal but any sort of bobble at all with anything exacerbates my adverse effects, especially in the morning dose. If I hold steady for a time, my body handles the adverse effects better. Therefore, at some point I have to face the music and try to reduce my overall mg starting with the morning dose, to reduce the adverse effects over time. I’m hoping as things move along, things will get better, even though I’m tapering.

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Altostrata

Yes, under the influence of lamotrigine, in the stable periods, your nervous system is learning to manage the activation from your prior drug reactions. Then it feels it doesn't need so much interference from lamotrigine and kicks back.

 

You will go through these cycles until you're off lamotrigine. My guess is you will be lowering the morning dose at fairly short intervals. A reduction will be signaled by those paradoxical reactions after a dose.

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Jmizz

@Altostrata

 

Gotcha, it’s just confusing to me that it all seemed to be triggered by the small drop. I guess bc I should have taken it off the morning dose and that reaction got worse. 
 

I plan to hold until I feel markedly better than the last few weeks. It’s been a real struggle. 
 

is watery eyes an adverse effect of lamotrigene?

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Altostrata
9 minutes ago, Jmizz said:

is watery eyes an adverse effect of lamotrigene?

 

Allergies?

 

As soon as you feel those paradoxical effects after a dose, it's time to reduce by a tiny amount. The paradoxical effects may be slight at first but will become stronger over days. Don't worry, the lamotrigine is your friend, it's letting you know what to do.

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Jmizz

@Altostrata

 

few more questions. Sorry I get needy when I struggle.

 

is it normal to feel like I’m back at the beginning in a lot of ways? And is heat intolerance a common thing for people, like not being able to stand the heat outside?. I live in south LA. I spend a lot of time outdoors as a coping mechanism since I still haven’t really been able to relax since this all started, except at night. It sucks now bc my outlet is 92-95 degree heat index now and I can’t hardly stand it. It prob gets worse when i slip back, this time it was a jump, maybe 2 jumps.

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Jmizz

@Altostrata

 

mainly keeping these notes to see how the dose drop timeline goes, just worried I was still really wobbly from the changes this past month. But anyway here goes:

 

5-28-20 (0.25 reduction)

Wake 645 restless til 8

800-11.5mg

800-900 anticipatory anxiety

1000-SI weird bc otherwise feel ok...could just be bc my attitude went pretty negative for a few days 

11-1 mainly just anxiety and fatigue, got tired easy outside felt like my heart was trying to race 

1-seem maybe sort of dosey

2-5mg

3-5 cut grass 

5-queasy ate dinner helped some

8-20.5

845-930 nausea restless leggy, face tingles

9:30 -traz Mel

1030-fall asleep 

230- wake back to sleep 

430- wake back to sleep

6-wake toss and turn til 8 

 

5-29-20

0600- wake restless til 8/mild headache burn/somewhat sore

0800-11.5mg banana/toast

0815- start getting fidgety 

0930- pretty uncomfortable/watery eyes

1000-feel okish

1030-some queasiness/watery eyes

1030-11 ugly

12-130 somewhat ok

130-2 maybe a little dosey

2-5mg

3-4 some queasiness/fatigue

5-fatigue and queasy need to eat  watery eyes

6-8 pretty damn uncomfortable 

8-20.5

830-seem pretty ok

9-traz 50 Mel 5

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Jmizz

@Altostrata

hey, today is going better than the last few. I will post notes later. I hope it continues and it isn’t a tease.

 

wanted to ask, as it seems I’ll be at this tapering thing for a while. What are the rules of carrying liquid doses on an airplane? Do you know. Like for instance if I had my daily doses or at least two of them premade in liquid. Could I go on an airplane with that?

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Altostrata

I don't know what's going on with air travel right now. I have traveled with premixed liquid doses in the past, I don't recall how I packaged them. Be sure to take your printed prescription slip for tablets.

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Jmizz

So it started good, midday was a struggle. It seems my mood is horribly affected by heat and sunlight. Is that a thing?

 

this all feels different than what I’ve experiencing the past few months. It’s like I regressed back several months but maybe some of the symptoms are less or gone. Hard to put a finger on what’s going on. 
 

from everything I’ve read on this site that usually means to hold? Any of you guys mind taking a peek in here and giving your opinions. Alto and I are trying to figure this out. It all started on April 18th with a small 0.25 reduction after a period of managing very well after a hold of around 2 months. If you guys have time and mind it all started with the posts in April.

 

@Shep @manymoretodays @brassmonkey

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Shep
4 minutes ago, Jmizz said:

So it started good, midday was a struggle. It seems my mood is horribly affected by heat and sunlight. Is that a thing?

 

Yes, many members do report upticks in symptoms due to heat. Make sure you're drinking plenty of water throughout the day and staying inside in air conditioning, if that's possible. 

 

Heat exhaustion and psychiatric drugs

 

Body temperature dysregulation: fever, chills, shivering, too hot, too cold, flashes, flushes

 

7 minutes ago, Jmizz said:

It all started on April 18th with a small 0.25 reduction after a period of managing very well after a hold of around 2 months.

 

What drug did you reduce? Lamictal? I'm having a very hard time reading through your drug and symptoms journals from that time frame. For instance, in this post, you have 12 mg and 5 mg listed, but no drug name.  You also have "traz" listed but no dose. Same problem in this post. And what is Mel5? If it's 5 mg of melatonin, it may be way too high a dose, which can cause paradoxical reactions. 

 

Please see:

 

Melatonin for sleep

 

Even if you've been on this high dose for a long time, it's possible your nervous system is more hypersensitive to things now, especially if it's being taxed with time spent out in heat and / or other stressors. 

 

 

Quote

-Lamictal (early October 2019 with doses as high as 50mg single dose, then split dose, now 3x daily with slight reductions since Jan 2020)

 

This is from your signature. It will help to have the doses and dates for the reductions you've made since January.  Your signature is here:

 

Account Settings - Create or Update Your Signature

 

 

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Jmizz

@Shep

 

sorry I will work on clarification. I’ve been mainly working with alto and she kind of has a sense of what’s going on with me.

 

i started at 50mg lamictal before I found SA reduced to 20-20 split dose at the end of November 2019. Reduced to 18.75 splits dose morning evening early December. Changed to 15-5-17.5 early January. Moved 2.5 to evening 2nd week of January for 12.5/5/20. Then shaved 0.5 off the morning to the evening end of January for 12-5-20.5. I held there until April 18th,2020. Aside from a blip with 5mg dispersibles and switching to taking all of my doses off the same 25mg tabs in water. Everything remained consistent from February 8th-April 18th. Daylight savings caused another brief blip it seemed moving my doses by 15 min each day. I showed a lot of improvement during that holding period with some minor weird symptoms here and there.

 

trazodone 50mg has remained consistent at 9pm since April of 2019. Melatonin 5mg has remained consistent since July 2019. I’m sleeping fine, even during this rough patch.

 

i reduced lamictal to 12-5-20.25 on April 18th. On May 16th we took 0.25 off the morning and added back to the evening as the negative effects in the morning dose seemed to worsen. So 11.75/5/20.5 and then 3 days ago we reduced the morning by 0.25 to 11.5/5/20.5.

 

the heat thing definitely worsens when I struggle. But I don’t seem to like the sun much at all since last April.

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Jmizz

@Altostrata

i see you had problems with the sun at some point. I know that was a long time ago but did you find some days were better than others or was it all the time, if you can recall.

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Jmizz

@Altostrata @Shep 

Sorry guys, I guess this hit me hard after feeling good for a bit. I need to just take a break and let my symptoms be for a bit bc getting on here embarrassing myself every couple hours isn’t helping. Stress is a big factor at the moment, I gotta work through that. Today was cloudy in the afternoon and it seemed better, I’m going to pay more attention to the sunlight and heat thing. The problem is I haven’t really been comfortable indoors since this started unless it’s after 8pm and I’m winding down for bed. Not being able to go outside in the heat and distract myself is going to take getting used to. There are times when I’m sure I create most of my problems by worry and letting myself stress. Sorry for blowing you guys up on here. I’ll try to calm down by focusing on other things for a couple days and see how it goes.

 

alto in all honesty if I wasn’t losing my mind obsessing today. I didn’t get nausea after the doses, my morning dose didn’t activate me much at all. I seemed to get dosey before 2 but I was outside in the heat before so I need to pay attention and try to limit outside during the hot hours. It seems I struggle with the transition back inside after I’ve been out in the heat. Withdrawal is weird....and hard.

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Shep
9 hours ago, Jmizz said:

So 11.75/5/20.5 and then 3 days ago we reduced the morning by 0.25 to 11.5/5/20.5.

 

the heat thing definitely worsens when I struggle. But I don’t seem to like the sun much at all since last April.

 

It takes 4 days for your nervous system to register a change and it can take a week or longer for your nervous system to acclimate to the change, so holding for a bit and staying out of the heat sounds like a good plan. 

 

Just a tip to help out moderators - please add "mg" to your doses. Also, I'm really not sure what "11.75/5/20.5" and "11.5/5/20.5" means. 

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Jmizz

@Shep

 

my lamotrigene doses are taken at 8am,2pm,8pm.

 

current dosing schedule 

 

8am- 11.5mg of lamotrigene

2pm- 5mg of lamotrigene

8pm- 20.5mg of lamotrigene

9pm- 50mg of trazodone and 5mg of melatonin

 

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Altostrata

Jmizz, heat sensitivity might indeed be a problem for you. And it must get pretty hot where you live.

 

I think the reduction in lamotrigine is going okay, the heat sensitivity is a legacy from the antidepressant withdrawal syndrome. Hang in there, try breathing through it.

 

My heat sensitivity very gradually went away.

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Jmizz

@Altostrata

 

i think I’ve been mildly allergic to this stuff the whole time. Often times within 30 minutes of taking it, somewhere in that 30 minutes I will sneeze several times. I’m thinking maybe that’s why I get the watery eyes sometimes also bc it isn’t like my normal allergies.
 

I think I just had compounding stress build up bc I convinced myself it’s going to be hard to get off this stuff. I don’t know the reaction from the drop was all that bad, I just worried every little feeling was bc of that and put myself into a stress wave. Looking back it seems a lot of my issues started with the increase in temperature. Yes it does get hot here. The last few days the heat index has been in mid 90s. When the wife works and I have my son all day he loves being outside and I’m finding I just can’t tolerate it very long so that’s just adding stress. One foot in front of the other.
 

 

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Altostrata
6 minutes ago, Jmizz said:

I just worried every little feeling was bc of that and put myself into a stress wave.

 

Now that you've observed this in yourself, you can talk yourself down, which would be a good habit for you to develop. Just breathe! can help a lot.

 

You might stay in the shade while your son is playing outside. Wear a straw hat, carry an iced drink, take it easy.

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Jmizz

@Altostrata

 

a fireman with heat intolerance, living in Louisiana. What a comedy. I’m going to write a book, I’ll have to sell it as fiction though, bc nobody will believe it, especially doctors. 
 

that’s a little slice of my pre-drug personality for you guys right there.

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Altostrata

A sensitive firefighter with heat intolerance in Louisiana!

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Jmizz

@Altostrata

 

had to throw another little jab in there, didn’t you! Haha

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ChessieCat

If it's a dry heat (I've no idea what it's like where you live), you might find putting a wet cloth around your neck (or cool it collar) and over your head might help.

 

My family was on holiday once when it was in the low 40s (celcius) and I was surprised that I wasn't feeling the heat like I normally did.  I then realised that I had a wet cotton t-shirt on.  As it dried out I got hotter, so I went and got it wet again.  It made a huge difference.  And during our hot summer in Australia I sometimes sat at the computer with a wet cloth around my head and shoulders.

 

If you are close to a power outlet you could also take a fan outside and sit in front of that.

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Jmizz

Hi @ChessieCat thanks for weighing in. Has this improved for you some? 
 

I live in Louisiana USA. Muggy heat, it’s terrible when you aren’t in ADWS haha. I’m going to start wearing a floppy hat and having a towel. Also I’ll bring one to work. I’m a fireman, isn’t that humorous?

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ChessieCat
Posted (edited)

I've always felt the heat.  I'm from English parents but born in Australia.  It's the humid heat that affects me most so I certainly can understand your discomfort.  Using wet things definitely won't help you unfortunately.

 

If you can sit somewhere where there is air flow it definitely helps so if you can arrange it so you can take a fan outside that would be a good option.

 

I've just done a search and you can buy rechargeable fans (no affiliation with produce or site).

 

Lazy-Neck-Hanging-Dual-Mini-Cooling-Fan-Sports-Rest-Portable-USB-Rechargeable

This is available in Australia.  I'd done a quick look for similar on ebay and amazon but don't have time to check them out thoroughly because there are lots of small ones listed.

 

https://www.jaycar.com.au/14-inch-ac-dc-rechargeable-oscillating-fan/p/GH1294

 

This one takes 6 D batteries which would be okay if you have rechargeable ones.

 

10-Inch-Portable-Desktop-Circulation

 

Edited by ChessieCat
added the last one

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Jmizz

Thanks @ChessieCat. My mother’s side is from North Dakota. I got some of those genes. Never been a huge fan of the heat but it’s rough now. I’m hoping it’s just bc it’s just starting to get real hot and I’ll adjust and it’ll become a little more manageable.

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ChessieCat

Yes, I find that if (though usually when because it always arrives too early for me because I love spring which never seems to last long enough), summer starts too early that my body doesn't seem to be prepared for it.

 

Perhaps you could break up the day by going out for short periods throughout the day which might be a compromise for everybody concerned.  And obviously to stay in during the hottest part of the day.  Or you could get up a bit earlier so that you can go outside for longer during the cooler part of the day.  Perhaps your son could have breakfast outside.  And have some interesting activities planned for your son when he is back inside.  If you have several organised you could allow him to choose what he would like to do.  If he is old enough you could get him to help plan the activities.

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Jmizz

@Altostrata

 

somewhat ok day today. I don’t feel the morning dose much. Had bone crushing fatigue between 12-2. Seemed to lift when I took the 5mg but then I had a spell of irritability this afternoon between 4-6. But I had a couple outside factors that contributed. Almost seems like the 5mg at 2pm is a little more uncomfortable than the morning dose now between 330-5. I’ll keep an eye on it. Not really getting dosey and I didn’t have very much nausea with this drop. Not nearly as bad as some of the past stuff. It was more queasy no appetite as opposed to the full blown nausea feeling. I’ll pay attention to how the heat effects this also.

 

i have a pipe dream of being able to taper off that afternoon dose, I wonder if I did it slowly if my system could learn to manage the 12 hour gap. 

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Altostrata
2 hours ago, Jmizz said:

Almost seems like the 5mg at 2pm is a little more uncomfortable than the morning dose now between 330-5.

 

I would not be a bit surprised if lamotrigine was telling you to reduce this dose next.

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