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Tips for tapering off Lamictal (lamotrigine)

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Altostrata

Lamotrigine is a epilepsy drug that is used in psychiatry as a "mood stabilizer" and treatment for bipolar disorder. It is rumored to have antidepressant properties. It tends to slow people down. One side effect is drowsiness.

Like all psychoactive drugs, lamotrigine can have withdrawal difficulties. Even doctors who are aware of withdrawal problems with other drugs can be surprised at how hard it is to go off lamotrigine. As with other drugs, we recommend very gradual tapering at 10% per month, based on the current dosage (the amount of the decrease keeps getting smaller). Read Why taper by 10% of my dosage?

Lamotrigine makes the nervous system less reactive. This allows regulatory systems, such as the GABA system, to work better. Much is unknown about how it works.
 
Removal of lamotrigine can cause a nasty rebound of "alerting," i.e. anxiety, restlessness, and sleeplessness.

Half-life is 25.4 to 32.8 hours. Dosing can be tricky as too much lamotrigine can cause adverse effects and the lowest effective dose varies from person to person. (For my personal experience with lamotrigine, see
One theory of antidepressant withdrawal syndrome )

FDA information from http://www.drugs.com/ppa/lamotrigine.html

Immediate-release lamotrigine is available in these dosages (NDC identification codes below for generic lamotrigine bottles of 100 tablets, from http://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=13638):

Dosages:
- Tablets 25 mg
- Tablets 100 mg
- Tablets 150 mg
- Tablets 200 mg
- Tablets, chewable dispersible 2 mg
- Tablets, chewable dispersible 5 mg (NDC 16252-597-01)
- Tablets, chewable dispersible 25 mg (NDC 16252-598-01)
- Tablets, orally disintegrating 25 mg
- Tablets, orally disintegrating 50 mg
- Tablets, orally disintegrating 100 mg
- Tablets, orally disintegrating 200 mg


The low-dose "chewable dispersible" tablets are mainly for children; "dispersible" means they can be dissolved and taken in water or fruit juice.

Your doctor must order the 2mg tablets directly from GlaxoSmithKline 1-800-334-4153 (NDC 0173-0699-00), which will supply two bottles of 30 tablets at a time, at no charge.

When your doctor needs more of the 2mg tablets, he or she will have to phone GSK again.
 
Brand-name GlaxoSmithKline Lamictal XR is available in the following dosages (per FDA http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3e2c9a35-6a39-41d7-ad84-3c0bb8894b09#section-2.4 ):
25 mg
50 mg
100 mg
200 mg
250 mg
300 mg
....
 

Conversion from Immediate-Release Lamotrigine Tablets to Lamictal XR
Patients may be converted directly from immediate-release lamotrigine to Lamictal XR extended-release tablets. The initial dose of Lamictal XR should match the total daily dose of immediate-release lamotrigine. However, some subjects on concomitant enzyme-inducing agents may have lower plasma levels of lamotrigine on conversion and should be monitored [see Clinical Pharmacology (12.3)].
 
....Depending on the therapeutic response after conversion, the total daily dose may need to be adjusted within the recommended dosing instructions (see Table 1).

 

LAMICTAL XR extended-release tablets contain a modified-release eroding formulation as the core. The tablets are coated with a clear enteric coat and have an aperture drilled through the coats on both faces of the tablet (DiffCORE™) to enable a controlled release of drug in the acidic environment of the stomach. The combination of this and the modified-release core are designed to control the dissolution rate of lamotrigine over a period of approximately 12 to 15 hours, leading to a gradual increase in serum lamotrigine levels.

 
Lamictal XR is intended for seizure control. Check to see if your insurance will cover it for any other diagnosis.
 
Cutting up tablets
The immediate-release tablets can be split -- I've cut up both chewable dispersible and regular tablets.

They're pretty small, though. If you're very sensitive to dosage reductions, you may wish to use a compounded liquid.
 
Given the formulation described above for the more expensive Lamictal XR tablets, it appears that if you cut up, they become immediate-release.

Tapering using combinations of tablets
If your doctor is willing to write prescriptions for tablet combinations (hint for insurance coverage: immediate-release lamotrigine is often taken twice a day), you can mix tablets to taper.

For example, you want to taper from 200mg immediate-release lamotrigine per day:

  • In addition to your usual prescription for 200mg tablets, request a prescription for 50mg tablets so you can cut them up to taper.
  • For example, for your first decrease you can take half a 200mg tablet (100mg) plus 1 50mg tablet plus 3/4 of a 50mg tablet = 187.5mg
  • Your second decrease would be half a 200mg tablet (100mg) plus 1 50mg tablet plus half of a 50mg tablet = 175mg
  • Your third decrease would be half a 200mg tablet (100mg) plus 1 50mg tablet plus 1/4 of a 50mg tablet = 162.5mg
  • Your fourth decrease would be half a 200mg tablet (100mg) plus 1 50mg tablet = 150mg
  • For your fifth decrease, probably in a few months, you'd get a prescription for 100mg tablets plus 25mg tablets and do something similar. And so forth.

Under 50mg, you can add the dispersible tablets for small decreases in dosage. But at that level, you may prefer to use a liquid to taper.
 
You can combine Lamictal XR tablets with immediate-release tablets to taper. Splitting Lamictal XR tablets, however, would not be any advantage over splitting immediate-release tablets -- the XR tablet becomes IR when cut up.
 
Have a compounding pharmacy make a liquid for tapering
Compounding pharmacies can make a liquid from the tablets. You will need a prescription written for the custom compound. The only drawback is this can be quite expensive.
 
Formula for a 1mg/1mL suspension made with Ora-Plus, a pharmacy liquid that is mostly water http://www.uspharmacist.com/content/c/54528/

Stability: A beyond-use date of up to 91 days may be used for this preparation.
...
Ora-Plus contains purified water, microcrystalline cellulose, sodium carboxymethylcellulose, xanthan gum, carrageenan, sodium phosphate, and citric acid as buffering agents; simethicone as an antifoaming agent; and potassium sorbate and methylparaben as preservatives.

 
Make your own liquid solution
According to Rhi's experience below, you can easily make a solution with your immediate-release lamotrigine tablets.

Crush tablet, dissolve in a measured amount of water, take with an oral syringe. See http://survivingantidepressants.org/index.php?/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/
 
Keep DIY liquids refrigerated for up to 7 days. You cannot make a liquid from Lamictal XR tablets.
 
Use a combination of tablets or capsules and liquid
Rather than switch directly to an all-liquid dose, you may wish to take part of your dose in liquid and part in lower-dose tablets or capsules, gradually converting to all liquid as you get to lower dosages. This can be very convenient and reduce any problems switching from one form of the drug to another.
 
If your doctor prescribes compounded liquid and tablets or capsules at the same time, most likely he or she will have to indicate "divided doses" in the prescriptions to get the drugs covered by insurance.

Edited by Altostrata
updated information

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Rhiannon

I use the conventional tablets because the dispersible ones aren't covered by my insurance. The ones I use (like all 5 of the drugs I'm liquid tapering now) dissolve just fine in plain water. (That is, the tablet itself dissolves. I don't think the lamotrigine itself dissolves in water. Only one of my meds is soluble in water.) I'd just add that like with any psych med, it's absolutely key with Lamictal to go very, very slowly and in small increments. At least, for me that has proven to be the key. Small increments, very slowly, with frequent holds.

 

Lamictal affects NMDA (glutamate) receptors (Alto knows a lot more about this than I do) and glutamate is our primary neurotransmitter. The main one. So if you're messing with Lamictal you're messing with some really important stuff, a lot of it, everywhere, Goddess only knows in how many ways, anything in our bodies that requires messages being sent and received, which is EVERYthing. So take it slowly and allow your body time to adapt to the changes before introducing further changes.

 

I really have become convinced that making changes incrementally and allowing the brain and nervous system enough time to actually remodel and adapt--stepwise, slowly--is absolutely key to successfully getting off psych meds. Alto, I skimmed that piece you wrote for Gianna's blog, will reread it more carefully (trying to do too many things in too little time today, as usual)--and you mentioned "dysfunctional homeostasis." I am SO glad you said that, I want to talk to you more about that. I've been thinking since fairly early on in my exploration of this stuff, that this is key to a lot of withdrawal syndrome symptoms, especially the prolonged w/d. You're the first other person I've read make any reference to this concept.

 

I suspect that when a drug that the brain has adapted to is removed suddenly, it's a life or death type crisis (or at least interpreted as such by the body), and the brain (which as I have mentioned elsewhere does not have any innate mechanisms for adapting to sudden changes in its chemistry) just struggles into some kind of homeostasis that works, that's better than dying--whatever conformation it can come up with. The first thing it can manage to come up with that is stable enough to support the organism's survival and basic functioning. And then it kind of stays stuck there because it's better than risking another life or death crisis. Plus, well, some other stuff, chemical equilibria, enzymes, epigenetic changes, et cetera--

 

oh, damn, I've been sitting at this computer way too long and I have errands I absolutely have to run right now so I can't go into this. You can edit this post if you want Alto but I really want to kick these ideas around with you when we get a chance. God it would be SO awesome to get together with you in person. These are subjects that cannot be appropriately and adequately thought through without lots of waving about of hands, I suspect. :-)

Edited by KarenB
added paragraph breaks

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Altostrata

Thanks, Rhi. Would love to meet you, too.

 

I think you've expressed a good understanding of the dysfunctional homeostasis in your post above.

 

I would say, though, that the nervous system doesn't perceive the issue as an emergency, it just accommodates to the weirdness of withdrawal the way it has always accommodated to biochemical changes, by turning up some functions and turning down others. I believe moving to a dysfunctional homeostasis can be a gradual process, accounting for the delay in withdrawal symptoms some people experience.

 

Thanks for the Lamictal tips, I'll expand post #1 more when I have time.

 

I've found making decreases in dosage works best for me at .1-.2mg per drop, but drops can be fairly frequent, such as every 4-5 days. What I'm doing now is a little "bridge": To make a .2mg drop, I decrease at .1mg the first day and another .1mg the second day, making .2mg over the 2 days. This completely eliminates any withdrawal symptoms.

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Rhiannon

Bumping this thread for selfish personal reasons.

 

Right now I'm mostly holding my taper on the benzos, very slowly continuing to reduce the citalopram, and pushing my Lamictal taper a bit faster. Going to have to hold now for a while though because I'm getting too many withdrawal symptoms. It's annoying but also interesting, because it's a slightly different complex of symptoms than I've had with my other med withdrawals. A lot of overlap of course but definitely unique in some ways.

 

I've had some bouts with the intense bone-deep fatigue many people report, but more of the time just a general sense of tiredness and low energy, just not wanting to move. Also generally feeling unmotivated about my life, some DP/DR, some of that "unable to experience the sensation of fun" (would that be anhedonia?), some problems with social interaction and not feeling connected to other people (something I used to have but which had receded a lot since I got my total med dosage load down).

 

And a resurgence of the problems with short term memory and word-finding and brain fog that I haven't had since I got off the Neurontin last summer.

 

Plus bouts of hypersensitivity to sounds, stimulation in general, and (oddly, a new one for me) cold temperatures. And headaches.

 

The most distinctive one is this NAUSEA. Not just nausea, but actual bouts of vomiting, sometimes intense, with shakes and chills. And general problems with my digestion, queasiness and sour stomach. At first I thought it was a couple of episodes with viruses, but it doesn't seem to really clear up permanently, and I've found a few other reports of nausea with vomiting with Lamictal withdrawal, so now I'm thinking it may be that.

 

(Guess it's time to get back to being rigorous about the GAPS diet.)

 

Anyway, I'd like to hear from other folks more about their Lamictal withdrawal symptoms. From looking around on the Internet it sounds like Lamictal withdrawal can be highly variable, with some people getting these symptoms and others not getting them at all. It's been helpful to me to read other folks' reports of their own withdrawal symptoms, validating and encouraging actually (plus kicking me in the butt that it's time to hold for a while, something I often need a firm reminder of). Seem to be many people looking around for information about this subject, besides just me.

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Rhiannon

Still having intermittent puking bouts with Lamictal withdrawal. Found some stuff possibly relevant about the connection between glutamate (the neurotransmitter that Lamictal blocks) and emesis (vomiting) in animal studies (the usual "let's torture some animals" science).

 

https://www.jstage.jst.go.jp/article/jphs/109/4/109_08333SC/_article

 

http://www.sciencedirect.com/science/article/pii/S0016508505013570 (love this one--their conclusion is that drugs that work on glutamate neurotransmission might be a good therapy for GERD. Oh sure, yeah, let's give potent brain-altering drugs with massive side effect profiles to people with GERD. Wonder who's funding THAT research...)

 

http://www.sciencedirect.com/science/article/pii/S0028390808000427 I don't really understand most of that abstract, except that it and many similar make it clear that glutamate receptor pathway function is incredibly complex and deeply involved in vagal nerve functions, which include all kinds of stuff involved in eating and digestion.

 

So really basically nothing new, except that it certainly could be Lamictal withdrawal causing the puking bouts and not some weird new intermittent virus that goes away when I hold my taper...

 

I wonder if I should make this a separate thread somewhere. Rhiannon's Interesting Journey Continues.

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Altostrata

At what point after reducing Lamictal do you get the nausea?

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Rhiannon

At what point after reducing Lamictal do you get the nausea?

 

Seems to come on 2-4 days or so after I make another small reduction. I'm reducing by about 0.5 mg at a time, then another 0.5 mg after four or five days, then holding until I notice a definite improvement.

 

I'm also still reducing other meds too, so I'm sure they're all interacting.

 

When the nausea settles down, the other withdrawal symptoms seem to settle down too, shortly afterwards.

 

I hate Lamictal. I can't seem to taper it with any kind of speed at all. 2-3 mg a month seems to be about as much as I can handle at this point. And I expect I will have to go slower once I get down to the lower doses. At 77.5 mg today.

 

Also just reduced my Xanax from 0.2 to 0.1975 and recently cut Celexa from 1.7 to 1.65, both typical reductions for me.

 

Just feeling so discouraged and tired and lonely and hopeless tonight. But I notice I was saying the same thing back in November, and I seem to recall having some much better spells this spring, so, wow, maybe it's withdrawal.

 

Always feels so real and final when it hits.

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Altostrata

Yeah. Could be an interaction with the other reductions. Lamotrigine nausea is known to happen when you're increasing, not decreasing.

 

Hang in there, Rhi. You're doing brilliantly.

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aileene

I appreciate your tips.  I am trying to reduce the Lamictal that I am taking.  Lately, I have been obsessing over the information I have been reading in the book "Anatomy of an Epidemic".  While I believe it is true, I feel badly and upset that I have been brainwashed by our society.  I have known for a long time that these drugs don't seem to help independence in life.  Instead I am on SSD, which of course I need but I have only been on it recently.  Throughout my life I was drugged and I wonder what would have happened if I had taken off the meds and taught life skills and had been given emotional and financial support until i could gain independence.  Now I am very lethargic and can barely hold down a part time, 20 hr a week job.  I am considering not working in the next year but it will be financially difficult and I would like to invest in some alternative care doctors which I won't be able to do if I quit working.  

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Imanhaffajee

Hi

 

I've just weaned off Lamicton and Lexamil (50mg lamicton, 5mg lexamil reduction per week, over 1 month) and am getting really light headed and dizzy all the time. Is there something I can do to stop this? Or is there any known info on how long this can last for?

I am trying to get off all medication, so is there anything I can do other than popping pills?

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Altostrata

You probably tapered too fast. Please read the above topic. You may wish to reinstate a very small amount of lamotrigine, 5mg-10mg, to lessen withdrawal symptoms, stabilize for some months, and taper more slowly from there.

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Rhiannon

Hi Tim. I'm doing much better now. Back in May I had been cutting a bit too much too fast and it really slammed me in July. I held my taper for about five weeks then made a few tiny cuts and now I'm holding it again, and starting to feel okay, even good on some days.

 

Your taper sounds extremely aggressive. I'm not surprised you're suffering classic withdrawal symptoms. We do not recommend 50% cuts ever. We recommend cutting no more than 10% of your current dose. So at 50 mg that would be 5 mg, and at 25 mg that would be 2.5 mg--all the way down to a very small dose.  

 

(Of course eventually you have to cut more than 10% to get all the way off, and your last cut will be 100%, but we recommend this be done only at very small fractional doses.)

 

It turns out that these drugs don't work in a linear way, and the smaller the doses the more slowly we need to taper.

 

(Nobody knows why, although I think it's a fascinating phenomenon and I would love to see some good science done on it. But the funding for drug studies comes from the people who $ell the drugs, so there's no research being done on helping people get off of them safely and permanently.)

 

I would suggest that you reinstate to about 40 mg now and hold there for a couple of weeks, and then begin a more moderate taper to the end. I think you'll save yourself a lot of suffering in the months (possibly years) to come. Up to you, of course.

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Rhiannon

Yeah. Could be an interaction with the other reductions. Lamotrigine nausea is known to happen when you're increasing, not decreasing.Hang in there, Rhi. You're doing brilliantly.

 

I think Gia says she also had nausea when tapering Lamictal. 

 

Not surprising--these drugs disrupt so many things in so many ways that they can have paradoxical effects that don't always seem to make sense.

 

In my case I think the working nights is contributing too.  Apparently there's something about the liver having its own circadian rhythm which is slower to reset than the melatonin/pineal one.

 

But the vomiting thing has been much less of a problem once I resigned myself to the fact that I'm just not going to be able to taper Lamictal faster than maybe 2 mg a month (more like 1.5 really).

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Altostrata

Well, we can record that nausea can also be due to too-fast tapering off lamotrigine. It must mess up the digestive system going up and coming down.

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mattinsmom

Nausea absolutely on day 5.  I'm working with a chiropractor and that seemed to help today. I think I forget how sick I was going up, at least that's what my family is telling me  ;) And I am learning that I am reducing too aggressively. But Lamictal and stomach - bad combo. 

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RubyTuesday

I've had some bouts with the intense bone-deep fatigue many people report, but more of the time just a general sense of tiredness and low energy, just not wanting to move. Also generally feeling unmotivated about my life, some DP/DR, some of that "unable to experience the sensation of fun" (would that be anhedonia?), some problems with social interaction and not feeling connected to other people (something I used to have but which had receded a lot since I got my total med dosage load down).

 

And a resurgence of the problems with short term memory and word-finding 

Plus bouts of hypersensitivity to sounds, stimulation in general, and (oddly, a new one for me) cold temperatures. And headaches.

 

 

I have been having all of the above withdrawal symptoms while tapering Lamictal. as well as hypersensitivity to light, and a kind of constellation of crying fits/headaches/back of the neck feels rigid/life feels totally pointless. and also I would describe the fatigue more like I am stumbling around in a fog literally bumping into walls, I am trying to tie my shoes and I am moving in slow motion.

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toomanymeds

No matter how slow I go down on Lamictal I have nausea. However, I have had nausea for a year and a half now even when I hold steady for months

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Rhiannon

I've been holding Lamictal for over a year now at 50 mg, focusing on benzos and also having a really stressful crazy year in 2105 where I didn't get much tapering done.

 

Anyway, just started tapering the Lamictal again, at 49 mg a day now. In 2016-2017 I hope to get my Lamictal and Valium doses down more, the other ones are already down to pretty low dosages and I feel like they're probably doing me less harm at this point.

 

I'll probably be taking it super slow, though. My daughter is having a baby in the spring and I want to be able to enjoy becoming a grandmother!

 

Thanks Ruby and toomany for your feedback, it's good to hear from other Lamictal taperers.

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Hibari

Hi Rhiannon,

 

I just wanted to say hi and let you know i am tapering Lamictal as well.  I am also tapering Mirtazapine-it was the first medication I tapered, then did them together starting in July 2015. 

 

I'm down to 50mgs of Lamictal and will start tapering again in mid February.

 

Anyway just wanted to offer my support. 

 

Hibari

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Rhiannon

Thanks Hibari! I just cut from 50 to 48 after holding at 50 for a year. Having some increased pain, which is typical for me.

 

Hang in there, we can do this!

 

I'll be taking it very slow, of course. I'm probably going to hold from mid March through June or July or so, because I have a grandbaby coming in early April.

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Hibari

I do the same thing, timing my cuts for big events or work commitments. 

 

I am considering my moving to a liquid suspension when I start tapering my Lamictal again.  I may be asking you for some math help when I do.

 

Wishing you a quick stabilization after this cut. 

 

H

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Rhiannon

I do the same thing, timing my cuts for big events or work commitments. 

 

I am considering my moving to a liquid suspension when I start tapering my Lamictal again.  I may be asking you for some math help when I do.

 

Wishing you a quick stabilization after this cut. 

 

H

Thanks! Having a rough morning today, woke up about 5 a.m. with a migraine. I doubt it's WD related, I get those from time to time, but it sure doesn't help on top of being WD wobbly.

 

I'm making up my Lamictal water suspension right now, actually. I dissolve a 100 mg tablet in 2 mL of water. 

 

If you do go to dissolving tablets, make sure that you don't cut right away. Just start out by making the liquid and give your body time to adjust to any changes that causes, see how it goes. Then when you're feeling like you're pretty stable and you've got the hang of it, you can start reducing. That's my approach anyway.

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Hibari

That makes sense.  When I switched from the pill form of Remeron to the liquid I had that experience. 

 

I have 25mgs tablets of Lamictal and a bunch of 5ml syringes from my Remeron taper. 

 

So I'm thinking I could put a 25mg tablet in a 5ml container and then start at 5ml on my syringe.  I am just talking this out and have some time to prepare.  

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Hibari

Hi,

 

I could use some assistance to figure out how to make a water based liquid suspension of my Lamictal.  I have reviewed tips for tapering Lamictal but I am looking for specific advice on the math part.  

 

I have 25mgs tablets at currently at a dose of 50mgs.  I also have 5ML syringes that I've been using with my Remeron wd. 

 

So, if I dissolve one 25mg tablet in 5ml of water and then start at the 5ML line of my syringe, will that be 25mgs? I was thinking 5ML of water times the 5ML syringe line equals 25mgs.  

 

Any help would be appreciated. 

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Rhiannon

I don't really follow the 5 mL of water times 5 mL logic, but think of it this way: If you dissolve a 25 mg tablet in 5 mL of water and then you drink the whole 5 mL, it has to be 25 mg of drug, because that's what you put in there, and you took all of it.

 

Anyway, 25 mg of drug in 5 mL of liquid gives you 5 mg of the drug in each 1 mL of the liquid, which gives you 1/2 mg of the drug in each 1/10 of a mL of liquid.

 

If your syringe has ten little marks between each mL, each of those is 1/10 of a mL, and you can easily reduce by 1/2 mg at a time. Sounds good to me, unless you know from experience that you need your cuts to be smaller than that.

 

I hope this makes sense. Explaining math and solutions in a written-word format is pretty much the hardest possible way to do it.

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Rhiannon

 

 

 

I'm making up my Lamictal water suspension right now, actually. I dissolve a 100 mg tablet in 2 mL of water. 

 

 

Oops, mis-wrote. I mean 100 mg tablet in 20 mL of water. 2 mL would be way too concentrated!

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Hibari

Thank you.

 

I actually have a syringe with 5 lines between each mark so I am figuring it out from there.  I am going to reread your directions again and then try to create my suspension in the next couple of days. 

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Rhiannon

5 lines will give you 1 mg per line so you can reduce by 1 mg at a time. If it gets to where (at the lowest doses) you want to reduce by smaller amounts, you can just add more water and make a less concentrated solution. But you don't need to worry about that for a while, you ought to be able to make 10% reductions pretty easily for a while.

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vetdoc

I've been holding Lamictal for over a year now at 50 mg, focusing on benzos and also having a really stressful crazy year in 2105 where I didn't get much tapering done.

 

Anyway, just started tapering the Lamictal again, at 49 mg a day now. In 2016-2017 I hope to get my Lamictal and Valium doses down more, the other ones are already down to pretty low dosages and I feel like they're probably doing me less harm at this point.

 

I'll probably be taking it super slow, though. My daughter is having a baby in the spring and I want to be able to enjoy becoming a grandmother!

 

Thanks Ruby and toomany for your feedback, it's good to hear from other Lamictal taperers.

Hi Rhi

 

Sorry to hear 2015 was a stressful year, I can relate.  Nice to see you starting your lamictal taper again.  I know you have been tapering multiple drugs for many years no. , I always admire your patience and strength on this long journey.  It's amazing that no matter how long one has been tapering the with drawls seem to hit hard when we resume a taper.   It never seizes to amaze me that we can feel pretty good for awhile and then get whacked again.   It seems so hard for our brain  to find a new homeostasis as we taper more of the drug it has been accustomed to for so long.  Thats why going so slow, as you taught me is the only way to go.

 

I wish you well with your lamictal taper.   Rhi congratulations on becoming a grandmother, enjoy your grandchild.

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Rhiannon

 

 

I wish you well with your lamictal taper.   Rhi congratulations on becoming a grandmother, enjoy your grandchild.

 

 

:-)))

Thanks!

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robcbar1

Hi all - I asked this question on a separate thread and looking for some immediate help.  I've been taking 5 mg of Lamictal for about 30 days to help quell my SSRI WD.  It's not doing anything for me and may actually be making some of my symptoms worse (namely derealization and tinnitus).  I'd like to stop but scared I'm going to get additional WD symptoms.  Have I been on it for a short enough time where I can cut down to 2.5 mg?  I know a 50% decrease is never advised but I hoping it's ok since I haven't been on it too long?  Any insight would be much appreciated.  Thanks.         

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RubyTuesday

Hi, This is a good question, I would be cautious and just try 10% reductions even though you have been on a short time, only because I also tapered off Lamictal and the depression was severe triggered by tapering. Of course I was on it for much longer, about 4 years, and also to help with SSRI withdrawals (11 years). I had tablets which dissolved in water so I used a beaker and took out 10% at a time. On the other hand since you have only been on a month you may well be fine with a faster taper. You can always give it 3 days and then play it by ear, reinstating and then going slower if the situation warrants. Good luck with that!

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ChessieCat
On 10/02/2018 at 1:38 AM, robcbar1 said:

Hi all - I asked this question on a separate thread and looking for some immediate help.  I've been taking 5 mg of Lamictal for about 30 days to help quell my SSRI WD.  It's not doing anything for me and may actually be making some of my symptoms worse (namely derealization and tinnitus).  I'd like to stop but scared I'm going to get additional WD symptoms.  Have I been on it for a short enough time where I can cut down to 2.5 mg?  I know a 50% decrease is never advised but I hoping it's ok since I haven't been on it too long?  Any insight would be much appreciated.  Thanks.         

 

My personal opinion is that I think it would be better, as RubyTuesday suggested, to try a 10% reduction and keep notes on paper.  If you feel okay you could try another 10% reduction sooner than the 4 weeks, eg between 2-3 weeks after.  I think tapering carefully would be better than risking too fast a taper.

 

On 22/08/2011 at 6:46 AM, Altostrata said:

Removal of lamotrigine can cause a nasty rebound of "alerting," i.e. anxiety, restlessness, and sleeplessness.

 

Yes, I think going cautiously is your best option.

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robcbar1
10 hours ago, RubyTuesday said:

Hi, This is a good question, I would be cautious and just try 10% reductions even though you have been on a short time, only because I also tapered off Lamictal and the depression was severe triggered by tapering. Of course I was on it for much longer, about 4 years, and also to help with SSRI withdrawals (11 years). I had tablets which dissolved in water so I used a beaker and took out 10% at a time. On the other hand since you have only been on a month you may well be fine with a faster taper. You can always give it 3 days and then play it by ear, reinstating and then going slower if the situation warrants. Good luck with that!

Hey Ruby - I went down to 2.5mg for 2 days last week and it was disastrous: major rebound anxiety and akathesia.  It's scary how powerful these drugs are even at small doses.  So I'm going to hold where I am for a bit @ 5 mg.  How are you doing overall?    Can I send you a message to learn more about how you converted Lamictal to a liquid?  I have the 5mg dissolvable tabs but I'm clueless on using a beaker etc.  

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RubyTuesday

Yes of course you can message me, I will say more later today. I am not surprised you got a bad rebound from a small drop. Every time I took a small drop, (I think it took me over 2 years to taper 50 mg) I got nasty suicidal depression mixed with a feeling that someone was banging me on the head. I am doing great and please do check in.

 

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