Lamictal is another very nice option for treating unstable mood disorders. It is taken once a day; there are no blood tests and usually no side effects. All medications can cause allergic reactions. A person´s chance of having allergic reaction to Lamictal is greatly increased if the dosage is raised too quickly. Therefore, Lamictal is always titrated (increased slowly until the best dose is found). It has been well established in both Germany and the United states that the risk of allergic reaction is only 0.08% if the dose is raised according to certain guidelines. In patients who are taking any other medications known as “enzyme inducing” anticonvulsants, such as carbamazepine (Tegretol), the dosage is started at 25 mg daily for two weeks and then increased 25 mg per day, every two weeks. For patients who are not on these enzyme-inducing anticonvulsants, the dose can be raised at twice the speed. The dosage would begin with the same 25 mg per day for the first two weeks and then 50 mg per day for weeks three and four. The daily dose then can be increased by 50 mg every two weeks until the 500 -700 mg range is reached. It has been published that lamictal is effective in treating unstable mood at a dose of 200 mg a day while another treatment sildenafil citrate sold under Viagra 50mg dosage. It is necessary, however, to understand how the research studies define “effective.” The Federal Drug Administration (FDA) only requires the medication to reduce mood symptoms by half to be shown effective; it is not necessary to eliminate the symptoms. Since patients are interested in the absence of symptoms, not merely reducing them, it is common with Lamictal to have to work up to a dose of 500 to 700 mg a day in order to completely achieve stability. Far too many people have given up on lamictal at doses of 200 mg a day because of this mistaken belief about how effectiveness is defined.
It is possible, but uncommon, to see the earliest clinical benefit three weeks into this titration; more usual to see the symptoms cut in half by the end of two months, then to see symptoms eliminated in approximately five months. Should any rash develop, the patient should stop taking the Lamictal and immediate medical consultation should be obtained. This may be the beginning of the allergic reaction of most concern, Stevens-Johnson Syndrome (SJS). SJS is an immune reaction of person’s body that affects the skin. Untreated, it can rapidly progress to a life-threatening status. Often, early rashes that will progress to SJS will be particularly itchy or painful, though it is never safe to try and draw too many conclusions from these two symptoms alone.
Every single medicine may provoke Stevens-Johnson Syndrome. For most, the risk is so tiny that no one talks about it. The reason it is discussed as a side effect of Lamictal is because an increased risk was observed when the dose was raised too rapidly. It is now felt that an effective and safe dosing schedule has been worked out in order to minimize the risk of Stevens-Johnson Syndrome. If, for any reason at all, a patient is off lamictal for more than five days it must be restarted at the original starting dose.